标题：主动脉内球囊反搏支持下急诊PCI治疗AMI合并 CS的临床研究

      作者：张燕锋，张勇，陈海坚    (高州市人民医院心内三科，广东 高州 525200)

      卷次： 2017年28卷1期

      【摘要】 目的 观察急性心肌梗死(AMI)合并心源性休克(CS)应用主动脉内球囊反搏(IABP)支持下急诊经冠状动脉介入术(PCI)治疗的临床效果。方法 选取2015年5月至2016年1月我院心内科收治的AMI合并CS患者87例，其中，41例行 IABP支持下PCI治疗患者为观察组，46例直接行PCI治疗患者为对照组，对比两组患者PCI手术前后心脏超声指标、心肌酶谱、神经功能指标及术后6个月不良心血管事件(MACE)发生率。结果 术后观察组与对照组患者的左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)分别为(52.12±6.43)%、(41.45±5.32) mm、(50.42±5.78) mm和 (46.79±5.67)%、（48.12±5.61）mm、(50.42±5.78) mm ，均较术前的(39.42±5.67)%、(54.69±6.78) mm、(60.23±6.98) mm和(38.81±5.34)%、(53.33±7.02) mm、(59.46±7.12) mm显著改善，且观察组均优于对照组，差异均有统计学意义(P<0.05)；术后观察组与对照组的肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白 I (cTnI)、心肌肌钙蛋白T (cTnT)分别为(22.49±3.42) U/L、(0.19±0.07) ng/mL、(0.13±0.03) ng/mL和(33.12±5.36) U/L、(1.03±0.28) ng/mL、(0.79±0.09) ng/mL均明显较术前的(134.32±26.43) U/L、(4.23±1.15) ng/mL、(1.35±0.81) ng/mL和(130.98±29.15) U/L、(4.31±1.19) ng/mL、(1.36±0.78) ng/mL明显降低，且观察组显著低于对照组，差异均有统计学意义(P<0.05)；术后 1个月、6个月，观察组的死亡率分别为 29.27%、41.46%，均明显低于对照组的56.52%、69.51%，差异均有统计学意义(P<0.05)。结论 IABP辅助支持PCI治疗AMI合并CS安全可行，其能够改善左室功能、降低死亡率和改善临床预后。
      【关键词】 急性心肌梗死；心源性休克；经冠状动脉介入术；主动脉内球囊反搏；预后
      【中图分类号】 R542.2+2 【文献标识码】 A 【文章编号】 1003—6350（2017）01—0029—04

Clinical study of emergency percutaneous coronary intervention under the support of intra-aortic balloon pumpin patients with acute myocardial infarction complicated with cardiac shock.
ZHANG Yan-feng, ZHANG Yong,CHEN Hai-jian. The Third Department of Cardiology, the People's Hospital of Gaozhou Province, Gaozhou 525200,Guangdong, CHINA
【Abstract】 Objective To observe the clinical effect of emergency percutaneous coronary intervention (PCI) un-der the support of intra-aortic balloon pump (IABP) in patients with acute myocardial infarction (AMI) complicated withcardiac shock (CS). Methods Eighty-seven patients of AMI complicated with CS in the Department of Cardiology inour hospital from May 2015 to January 2016. Among them, 41 patients treated by PCI under the support of IABP wereenrolled as the observation group, and 46 patients undergoing PCI were included in the control group. Cardiac ultra-sound index, myocardial enzyme spectrum, neural function before and after PCI and adverse cardiovascular events(MACE) incidence at postoperative 6 months were compared between the two groups. Results After operation, leftventricular function of left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDd), left ven-·论 著·doi:10.3969/j.issn.1003-6350.2017.01.009