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急性心肌梗死后心源性休克患者长时间主动脉内球囊反搏的效果

Effect of prolonged intra-aortic balloon pumping in patients with cardiogenic shock following acute myocardial infarction.

作者信息

Li Jin-long, Xue Hong, Wang Bo-song, Zhang Huan-Yi, Yin Lu-Hua, Shun Wei-dong, Wu Yun, Wang Le-xin

机构信息

Department of Cardiology, Taian Center Hospital Shandong 271000, PR China.

出版信息

Med Sci Monit. 2007 Jun;13(6):CR270-74.

Abstract

BACKGROUND

To evaluate the efficacy of prolonged intra-aortic balloon pumping (IABP) support in patients with cardiogenic shock following acute myocardial infarction (AMI).

MATERIAL/METHODS: Thirty-nine patients with cardiogenic shock after AMI were treated with percutaneous coronary intervention which was supported by IABP. After 72 hours of IABP, the patients who attained the criteria of IABP withdrawal were randomly divided into two groups. The control group ceased IABP whereas the study group continued IABP for additional seven days.

RESULTS

After IABP, mean arterial pressure, cardiac index, left ventricle ejection fraction and arterial oxygen saturation were significantly elevated in all patients whereas pulmonary capillary wedge pressure and heart rate were decreased. The improvement of cardiac index, left ventricular ejection fraction and pulmonary capillary wedge pressure in the study group was greater than the control group (P<0.05). After 12-month follow-up, the 6-min walking test and left ventricular ejection fraction in the study group were significantly higher than those of the control group (P<0.05). No significant differences were noted between the two groups in the incidence ventricular aneurysm and mortality rate.

CONCLUSIONS

Prolonged use of IABP for up to 10 days offers additional long term benefit in left ventricular function and exercise tolerance.

摘要

背景

评估延长主动脉内球囊反搏(IABP)支持对急性心肌梗死(AMI)后心源性休克患者的疗效。

材料/方法:39例AMI后心源性休克患者接受经皮冠状动脉介入治疗并辅以IABP。IABP治疗72小时后,达到IABP撤机标准的患者被随机分为两组。对照组停止IABP,而研究组继续IABP治疗额外7天。

结果

IABP治疗后,所有患者的平均动脉压、心脏指数、左心室射血分数和动脉血氧饱和度均显著升高,而肺毛细血管楔压和心率降低。研究组心脏指数、左心室射血分数和肺毛细血管楔压的改善程度大于对照组(P<0.05)。12个月随访后,研究组的6分钟步行试验结果和左心室射血分数显著高于对照组(P<0.05)。两组在室壁瘤发生率和死亡率方面无显著差异。

结论

将IABP延长使用至10天对左心室功能和运动耐量有额外的长期益处。

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