Iakobishvili Zaza, Hasdai David
Intensive Cardiac Care Unit, Department of Cardiology, Rabin Medical Center, Beilinson Campus, 39 Jabotinsky Street, Petah Tikva, Israel 49100.
Med Clin North Am. 2007 Jul;91(4):713-27; xii. doi: 10.1016/j.mcna.2007.02.007.
The treatment of cardiogenic shock complicating the acute coronary syndromes consists of medical therapy, percutaneous revascularization procedures, cardiac surgery, and the implantation of devices. Medical therapy is limited to different positive inotropic and vasoactive drugs, without any firm evidence of survival benefit using these drugs. Several new pharmacologic compounds are at different stages of clinical research, but are not yet routinely approved for the treatment of cardiogenic shock. The only evidence-based therapy with proven survival benefit is timely revascularization. Intra-aortic balloon pump counterpulsation maintains its central role as supportive treatment in cardiogenic shock patients. Anecdotal evidence is available about the use of ventricular assist devices, cardiac resynchronization therapy, and emergent heart transplantation.
急性冠状动脉综合征并发心源性休克的治疗包括药物治疗、经皮血管重建术、心脏手术和装置植入。药物治疗仅限于使用不同的正性肌力药和血管活性药物，尚无确凿证据表明使用这些药物能带来生存获益。几种新的药物化合物正处于临床研究的不同阶段，但尚未常规批准用于治疗心源性休克。唯一经证实有生存获益的循证疗法是及时进行血管重建。主动脉内球囊反搏在治疗心源性休克患者中作为支持治疗仍发挥着核心作用。关于使用心室辅助装置、心脏再同步治疗和紧急心脏移植有一些轶事性证据。
