主动脉内球囊反搏降低暴发性心肌炎患者的住院死亡率  

Intra-aortic balloon pump reduces in-hospital mortality in patients with fulminant myocarditis

作　　者：周宁[1] 舒鸿洋 杭伟健 李娜 吴东阳 蒋建刚[1] 汪道文[1] ZHOU Ning;SHU Hong-yang;HANG Wei-jian;LI Na;WU Dong-yang;JIANG Jian-gang;WANG Dao-wen(Division of Cardiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院心血管内科,湖北武汉430030

出　　处：《内科急危重症杂志》2022年第6期460-463,491,共5页Journal of Critical Care In Internal Medicine

基　　金：国家自然科学基金(No:82070316)。

摘　　要：目的:评价主动脉内球囊反搏(IABP)治疗对暴发性心肌炎(FM)患者院内死亡率的影响。方法:选取100例FM患者,根据患者在入院后30 min内是否应用IABP分为2组,其中接受IABP治疗(IABP组)57例(57%),而未接受IABP治疗(非IABP组)43例(43%),评估患者住院死亡率(整个住院周期内)、血流动力学变化、心功能和心肌损伤情况。结果:100例患者中,死亡29例(29%)。非IABP组住院死亡率显著高于IABP组患者(34.9%vs 24.6%,P<0.01)。与非IABP组比较,IABP组患者死亡风险降低了29.5%。入院时,2组患者的平均血压(MBP)、平均心率(AHR)、左室射血分数(LVEF)比较,差异无统计学意义(P均>0.05)。但与非IABP组比较,IABP组植入治疗30 min后收缩压(SBP)、舒张压(DBP)显著升高,AHR明显降低,IABP组患者植入24 h后LVEF值明显升高,同时血管活性药物剂量显著减少。结论:IABP治疗可降低FM患者住院死亡风险,改善患者心功能和血流动力学不稳定状态。Objective:To evaluate the effect of intra-aortic balloon pump(IABP)on in-hospital mortality in patients with fulminating myocarditis(FM).Methods:A total of 100 patients with FM were selected and divided into 2 groups according to whether they were treated with IABP within 30 min after admission.Of the 100 patients with FM,57(57%)received IABPs within 30 min after admission(IABP group),whereas 43(43%)did not(non-IABP group).Patients'in-hospital mortality,hemodynamic changes,cardiac function,and biomarkers of myocardial injury were evaluated.Results:Of the 100 patients,29(29%)died.The in-hosptial mortality in non-IABP group was significantly higher than in the IABP group(34.9%vs 24.6%,P<0.01).The use of IABP reduced the mortality risk of FM in patients by 29.5%.There were no significant differences in mean blood pressure(MBP),average heart rate(AHR)and left ventricular ejection fraction(LVEF)between the two groups on admission(all P>0.05).However,compared to the non-IABP group,SBP,DBP and LVEF were increased and AHR was significantly decreased 30 min after IABP implantation.Application of the IABP significantly decreased the dose of vasopressors and inotropic agents.Conclusion:IABP reduced the in-hospital mortality risk and improved the hemodynamic instability,cardiac dysfunction in patients with FM.

关 键 词：主动脉内球囊反搏 暴发性心肌炎 机械循环支持 心源性休克 院内死亡率 

分 类 号：R542.2[医药卫生—心血管疾病]