联合应用PCI术IABP治疗心肌梗塞患者的疗效分析  

Analysis of the Curative Effect of Combined PCI and IABPin the Treatment of Patients with Myocardial Infarction

作　　者：庞芹[1] 张杨春 李璐娜 PANG Qin;ZHANG Yangchun;LI Luna(Chengdu Third People's Hospital,Sichuan Chengdu 610031,China)

机构地区：[1]四川省成都市第三人民医院心内科,四川成都610031

出　　处：《河北医学》2022年第11期1850-1854,共5页Hebei Medicine

基　　金：四川省卫生健康科研课题普及项目,(编号:19PJ168)。

摘　　要：目的:探究主动脉球囊反搏(IABP)联合经皮冠脉介入(PCI)治疗急性心肌梗塞(AMI患者对其术后心功能低下的影响。方法:回顾性分析2014年8月至2021年4月我院收治的81例AMI患者一般临床资料,根据患者治疗方式分组,将单纯采用PCI手术治疗者纳入对照组(n=39),将IABP联合PCI治疗者纳入研究组(n=42),分析比较两组患者心功能、血流动力学及血清脑钠肽(BNP)、高敏肌钙蛋白T(TNT-HS)、肌酸激酶同工酶(CK-MB)水平变化情况,并记录不良反应。结果:治疗1周后两组TNT-HS、CK-MB、BNP、肺动脉楔压(PCWP)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均显著降低,有创平均动脉压(MABP)、有创动脉收缩压(SBP)、左室射血分数(LVEF)升高,且研究组以上指标治疗前后差值均显著高于对照组(P<0.05);研究组恶性心律失常、再次心肌梗死、心力衰竭等不良心血管事件发生率均显著低于对照组,差异有统计学意义(P<0.05)。结论:联合应用PCI术、IABP治疗,可有效改善AMI患者血流动力学指标,降低BNP、CK-MB、TNT-HS水平,有效促进心功能恢复,值得在临床推广应用。Objective:To explore the effect of aortic balloon counterpulsation(IABP)combined with percutaneous coronary intervention(PCI)in the treatment of acute myocardial infarction(AMI)patients on postoperative cardiac dysfunction.Methods:The general clinical data of 81 patients with AMI admitted to the hospital between August 2014 and April 2021 were retrospectively analyzed.Patients enrolled were grouped according to the treatment method.Those treated with PCI alone were included in the control group(n=39),and those treated with IABP combined PCI were included in the study group(n=42).The changes in cardiac function,hemodynamics,serum Brain natriuretic peptide(BNP),High-sensitivity troponin T(TNT-HS),Creatine kinase isozyme(CK-MB)levels were compared between the two groups.Adverse reactions were recorded.Results:After 1 week of treatment,TNT-HS,CK-MB,BNP,pulmonary wedge pressure(PCWP),left ventricular end diastolic diameter(LVEDd)and left ventricular end systolic diameter(LVESD)were significantly decreased in the two groups,and the invasive mean arterial pressure(MABP),invasive arterial systolic pressure(SBP)and left ventricular ejection fraction(LVEF)were increased,and the difference between the above indicators in the study group before and after treatment was significantly higher than that in the control group(P<0.05).The incidence rates of adverse cardiovascular events such as malignant arrhythmia,recurrent myocardial infarction,and heart failure in the study group were significantly lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion:Combined treatment of PCI and IABP for patients with AMI can effectively improve their hemodynamics,reduce BNP,CK-MB and TNT-HS levels,and effectively promote cardiac function recovery.

关 键 词：主动脉球囊反搏 急性心肌梗塞 经皮冠脉介入 心功能低下 

分 类 号：R542.22[医药卫生—心血管疾病]