摘要
目的探讨主动脉内球囊反搏术(IABP)辅助治疗大面积ST段抬高型急性心肌梗死并发心源性休克的效果。方法选择2016年6月至2018年9月南京明基医院收治的84例大面积ST段抬高型急性心肌梗死并发心源性休克患者为研究对象,将患者随机分为经皮冠状动脉介入术(PCI)组和IABP组,每组42例。PCI组患者接受PCI治疗,IABP组患者接受IABP辅助PCI治疗。比较2组患者手术前及手术后24h平均动脉压(MAP)、中心静脉压(CVP)、心率(HR)、左心室射血分数(LVEF)、血清氨基末端脑钠尿肽前体蛋白(NT-proBNP)及超敏C反应蛋白(hs-CRP)水平;比较2组患者术后30d主要心血管不良事件(MACE)发生情况。结果2组患者术前MAP、CVP、HR及LVEF比较差异均无统计学意义(P>0.05);2组患者术后24h的MAP、LVEF显著高于术前(P<0.01),CVP及HR显著低于术前(P<0.01);术后24h,IABP组患者的MAP、LVEF显著高于PCI组,CVP及HR显著低于PCI组(P<0.01)。2组患者术前血清NT-proBNP和hs-CRP水平比较差异无统计学意义(P>0.05);2组患者术后24h的血清NT-proBNP和hs-CRP水平均显著低于术前(P<0.01);术后24h,IABP组患者血清NT-proBNP和hs-CRP水平显著低于PCI组(P<0.01)。PCI组和IABP组患者术后MACE发生率分别为47.6%(20/42)、23.8%(10/42),IABP组患者MACE发生率显著低于PCI组(χ^2=5.185,P<0.05)。结论IABP辅助PCI治疗大面积ST段抬高型急性心肌梗死并发心源性休克的效果显著,且患者术后MACE发生率低,可改善患者的预后。
Objective To explore the effect of intra-aotric balloon pump(IABP) in the treatment of ST-segment elevation myocardial infarction complicated with cardiogenic shock. Methods Eighty-four patients with ST-segment elevation myocardial infarction complicated with cardiogenic shock admitted to Benq Medical Center of Nanjing were selected and randomly divided into percutaneous coronary intervention(PCI) group and IABP group,with 42 patients in each group. The patients in the PCI group were given PCI treatment,and the patients in the IABP group were given IABP and PCI treatment.The mean arterial pressure(MAP),central venous pressure(CVP),heart rate(HR),left ventricular ejection fractions(LVEF)and the levels of serum N terminal pro B type natriuretic peptide(NT-proBNP) and hypersensitive C-reactive protein(hsCRP) were compared between the two groups before and 24 h after operation;the incidence of major adverse cardiovascular events(MACE) were compared between the two groups at 30 days after surgery. Results There was no significant difference in the MAP,CVP,HR and LVEF of patients between the two groups before operation(P > 0. 05);the MAP and LVEF of patients at 24 hours after operation were significantly higher than those before operation in the two groups(P < 0. 01),and the CVP,HR were significantly lower than those before operation(P < 0. 01);the MAP and LVEF of patients in the IABP group were significantly higher than those in the PCI group at 24 hours after operation,and the CVP,HR were significantly lower than those in the PCI group at 24 hours after operation(P < 0. 01). There was no significant difference in the serum NT-proBNP and hs-CRP levels between the two groups before operation(P > 0. 05);the levels of serum NT-proBNP and hs-CRP of patients at 24 hours after operation were significantly lower than those before operation in the two groups(P < 0. 01);the levels of serum NT-proBNP and hs-CRP of patients in the IABP group were significantly lower than those in the PCI group at 24 hours after operation(P < 0.
作者
陈旭华
姜雯
CHEN Xu-hua;JIANG Wen(Department of Emergency,Benq Medical Center of Nanjing,Nanjing 210000,Jiangsu Province,China)
出处
《新乡医学院学报》
CAS
2019年第9期879-882,共4页
Journal of Xinxiang Medical University
