PCI术前应用IABP对急性大面积STEMI患者的临床疗效评估

目的评价主动脉内气囊反搏术(IABP)在失去急诊经皮冠状动脉介入(PCI)的急性大面积ST段抬高型心肌梗死(STEMI)患者PCI术前尽早应用的临床疗效。方法 150例发病12～72h之间的STEMI患者,随机分为2组,试验组72例,对照组78例,两组患者入院后均给予规范的药物治疗,试验组在规范药物治疗的基础上尽早床旁应用IABP。两组均于入院10-14d后行冠脉造影必要时PCI术,观察术后4周心功能、左心室及左心房大小、左心室射血分数(Left ventricle ejection fraction,LVEF)及主要不良心脏事件(MACE)的发生情况。结果两组PCI术后4周MACE事件的发生率、LVEF、临床心功能差异均有统计学意义(P﹤0.05)。结论对于大面积STEMI患者择期行PCI,尽早床旁应用IABP能改善心功能,减少MACE事件的发生率,临床应用安全可行,对近期预后是有利的。

Therapeutic efficacy of intra-aortic balloon pump in STEMI patients before elective percutaneous coronary intervention

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 150 STEMI patients were randomized into two groups:72 patients in test group and 78 in control group.All the individuals onset of STEMI had been 12-72 hours,the patients in test group receiving IABP support treatment and the patients in control group not.All the individuals were performed PCI after 10 to 14 days.Cardiac structure and cardiac ventricle systolic function including left atrium medial diameter(LAMD),left ventricular medial diameter(LVMD),left ventricular ejection fraction(LVEF)were evaluated after 4 weeks.Finally,statistics was taken to analyze the data.The major adverse cardiac events(MACE)and heart function at 4 weeks were studied.RESULTS In test group,the occurrence of MACE after 4 weeks completed surgery,left ventricle ejection fraction(LVEF)was significantly different in two groups(P﹤0.05).CONCLUSION Early application of IABP on patients with STEMI for elective PCI is safe and effective,which can reduce the incidence of MACE,and improve LVEF.