经皮冠状动脉介入治疗联合主动脉内球囊反搏术治疗急性心肌梗死伴心源性休克患者的效果  

Effects of percutaneous coronary intervention combined with intra-aortic balloon counterpulsation in treatment of patients with acute myocardial infarction complicated with cardiogenic shock

作　　者：张利花[1] 吕建华[2] 宋颖飞[1] ZHANG Lihua;LYU Jianhua;SONG Yingfei(Puyang People’s Hospital,Emergency Intensive Care Unit,Puyang 457000 Henan,China;Puyang People’s Hospital,Department of Pharmacy,Puyang 457000 Henan,China)

机构地区：[1]濮阳市人民医院急诊重症监护室,河南濮阳457000 [2]濮阳市人民医院药学部,河南濮阳457000

出　　处：《中国民康医学》2025年第9期46-48,52,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察经皮冠状动脉介入治疗(PCI)联合主动脉内球囊反搏术(IABP)治疗急性心肌梗死伴心源性休克患者的效果。方法:选取2021年5月至2023年2月该院收治的86例急性心肌梗死伴心源性休克患者进行前瞻性研究,按照随机数字表法将其分为对照组与观察组各43例。对照组采用PCI治疗,观察组在对照组基础上联合IABP治疗。比较两组手术前后血流动力学指标[肺动脉楔压(PCWP)、收缩压、舒张压、平均动脉压(MAP)]、心功能指标[左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]、血清学指标[血肌酐(Cr)、超敏C反应蛋白(hs-CRP)、B型脑钠肽(BNP)]水平,以及随访1年后存活率和复发率。结果:术后,两组MAP、收缩压、舒张压水平均高于治疗前,且观察组高于对照组,两组PCWP水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);术后1、2周,两组LVEF水平均高于术前,且观察组高于对照组,两组LVEDD水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);术后,两组Cr、hs-CRP、BNP水平均低于术前,且观察组低于对照组,差异有统计学意义(P<0.05);随访1年后,观察组存活率为88.37%(38/43),高于对照组的67.44%(29/43),差异有统计学意义(P<0.05);两组复发率比较,差异无统计学意义(P>0.05)。结论:PCI联合IABP治疗急性心肌梗死伴心源性休克患者可改善血流动力学指标水平、心功能指标水平和存活率,降低血清学指标水平,效果优于单纯PCI治疗。Objective:To observe effects of percutaneous coronary intervention(PCI)combined with intra-aortic balloon counterpulsation(IABP)in treatment of patients with acute myocardial infarction complicated with cardiogenic shock.Methods:86 patients with acute myocardial infarction complicated with cardiogenic shock admitted to this hospital from May 2021 to February 2023 were selected for the prospective study.According to the random number table method,they were divided into control group and observation group,43 cases in each group.The control group was treated with PCI,while the observation group was treated with IABP on the basis of that of the control group.The levels of hemodynamic indexes[pulmonary artery wedge pressure(PCWP),systolic blood pressure,diastolic blood pressure,mean arterial pressure(MAP)],cardiac function indexes[left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)]and serological indexes[serum creatinine(Cr),high-sensitivity C-reactive protein(hs-CRP),B-type brain natriuretic peptide(BNP)]before and after the surgery,the survival rate,and the recurrence rate after 1 year of follow-up were compared between the two groups.Results:After the surgery,the levels of MAP,systolic blood pressure and diastolic blood pressure in the two groups were higher than those before treatment,and those in the observation group were higher than those in the control group;the PCWP levels of the two groups were lower than those before treatment,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).1 and 2 weeks after the surgery,the LVEF levels of the two groups were higher than those before the surgery,and that in the observation group was higher than that in the control group;the LVEDD levels of the two groups were lower than those before the surgery,and that in the observation group was lower than that in the control group;and the differences were statistically significant(P<0.05).After the surgery,the leve

关 键 词：急性心肌梗死 心源性休克 经皮冠状动脉介入治疗 主动脉内球囊反搏术 血流动力学 心功能 

分 类 号：R542.2[医药卫生—心血管疾病]