主动脉内球囊反搏对急性心肌梗死合并心源性休克老年患者介入术后炎性因子的影响

目的评价主动脉内球囊反搏(IABP)对急性心肌梗死(AMI)合并心源性休克老年患者PCI后炎性因子可溶性CD40配体(sCD40L)的影响。方法选择90例AMI合并心源性休克老年患者分为治疗组42例(IABP行PCI)和对照组48例(直接行PCI);分别测定入院时以及第1、7天的sCD40L水平;比较2组PCI术后1周、3个月的LVEF,随访患者术后6个月的主要不良心脏事件。结果治疗组第1、7天的sCD40L水平明显低于对照组(3.19±0.39)μg/Lvs(3.51±0.42)μg/L,(2.98±0.34)μg/Lvs(3.12±0.41)μg/L,P<0.05];治疗组患者术后1周、3个月的LVEF较对照组明显改善(36.11±6.31)%vs(30.26±5.48)%,(44.69±5.02)%vs(41.52±4.17)%,P<0.05)];而2组术后6个月的主要不良心脏事件比较,差异无统计学意义(P>0.05)。结论 AMI合并心源性休克的老年患者,急诊PCI术前采用IABP辅助支持治疗能明显降低术后sCD40L水平,能有效地改善左心室功能,并且安全有效。

Effect of intra-aortic balloon pump on inflammatory factor in elderly AMI patients with cardiogenic shock after PCI

Objective To assess the effect of intra-aortic balloon pump(IABP)on inflammatory factor sCD40 Lin AMI patients with cardiogenic shock(CS)after PCI.Methods Ninety AMI elderly patients with CS were divided into treatment group(n=42)and control group(n=48).Their sCD40 Llevel was measured at admission and on days 1and 7after admission.Their left ventricular function(LVEF)was compared 1week and 3months after PCI.The patients were followed up for 6months after PCI,during which the MACE were recorded.Results The sCD40 Llevel was significantly lower in treatment group than in control group on days 1and 7after PCI(3.19±0.39μg/L vs 3.51±0.42μg/L,2.98±0.34μg/L vs 3.12±0.41μg/L,P<0.05).The LVEF was better in treatment group than in control group 1week and 3months after PCI(36.11%±6.31%vs 30.26%±5.48%,44.69%±5.02%vs 41.52%±4.17%,P<0.05).However,no significant difference was found in the incidence of MACE between the two groups 6months after PCI(P>0.05).Conclusion IABP can significantly reduce the sCD40 Llevel in elderly AMl patients with CS before PCI and effectively improve their LVEF.