择期PCI大面积STEMI患者术前应用IABP临床预后观察

目的研究择期行经皮冠状动脉介入治疗(PCI)的大面积急性ST段抬高型心肌梗死(STEMI)患者早期应用主动脉内气囊反搏术(IABP)对临床预后的影响。方法选取发病12～72 h的STEMI患者100例,随机分为两组,IABP组52例、对照组48例,对照组给予规范的药物治疗,IABP组在规范药物治疗的基础上床旁应用IABP 3～5 d。两组均于10～14 d后行冠脉造影及PCI术。评价梗死相关血管PCI术前及术后冠脉血流(TIMI)和术后4周心功能及主要不良心脏事件的发生情况。结果 IABP组PCI术前、术后TIMIⅢ级高于对照组,PCI术后4周主要不良心脏事件的发生率低于对照组,左心室射血分数高于对照组,P均<0.05。结论对于大面积STEMI患者择期行PCI,早期应用IABP能改善梗死相关血管的TIMI血流,减少术后4周主要不良心脏事件的发生率,改善心功能,临床应用安全有效。

Effects of early application of IABP on clinical prognosis of STEMI patients with elective PCI

Objective To evaluate the effect of early application of intra-aortic balloon pump counterpulsation(IABP) on patients with ST-segment elevation acute myocardial infarction(STEMI) for elective percutaneous coronary interventional(PCI).Methods One hundred STEMI patients were randomized into test group(n=52) and control group(n=48).All the individuals onset of STEMI had been 12-72 hours.The patients in test group received IABP support treatment for 3-5 days.All the individuals were performed PCI after 10-14 days.Thrombolysis in acute myocardial infarction(TIMI) grade was studied before and after PCI.The major adverse cardiac events(MACE) and heart function at 4 weeks were studied.Result In test group,TIMI Ⅲ flow rate was significantly higher than that in control group after PCI(P<0.05),the occurance of MACE at 4 weeks was significantly lower than that in control group(P<0.05),and left ventricle ejection fraction(LVEF) was significantly higher than that in control group(P<0.05).Conclusion Early application of IABP on patients with STEMI for elective PCI is safe and effective,which can reduce the occurance of MACE at 4 weeks,and improve LVEF.