尼泊尔一家新兴心脏中心对急性心肌梗死合并心源性休克患者进行的直接经皮冠状动脉介入治疗（PPCI）
Primary Percutaneous Coronary Intervention (PPCI) in acute myocardial infarction complicated with cardiogenic shock in a newly emerging cardiac center in Nepal.
作者信息
Maskey Arun, Regmi Shyam Raj, Dubey Laxman, Bhatt Yadab, Malla Rabi, Limbu Yuba Raj, Sharma Deewakar, Bahadur Man
机构信息
Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal.
出版信息
J Res Med Sci. 2009 Mar;14(2):123-7.
BACKGROUND
Acute myocardial infarction (AMI) is complicated by cardiogenic shock in 7~10% of patients. Mortality rate is exceedingly high and reaches 70-80% in those treated conservatively. Large thrombolytic trials demonstrate 60% mortality with most effective thrombolytic agent.
METHODS
In between September 2005 to August 2008 total PCI in Shahid Gangalal National Heart Center (SGNHC) in Nepal was 452. Among them primary PCI (PPCI) in AMI with cardiogenic shock was done in only 16 patients (3.5%).
RESULTS
This study showed in-hospital mortality of 50% (n = 8). Of 50% (n = 8) alive patients with cardiogenic shock who underwent PPCI, 6 patients are in routine follow-up over 12 months and 2 were doing well in subsequent 6 months but not in follow up after that.
CONCLUSION
Primary PCI in AMI complicated by cardiogenic shock has lower mortality and improved outcome. High cost, high in-hospital mortality and lack of trained personnel are major limitations.
背景
7%至10%的急性心肌梗死（AMI）患者会并发心源性休克。死亡率极高，保守治疗患者的死亡率达70%至80%。大型溶栓试验表明，使用最有效的溶栓药物时死亡率为60%。
方法
2005年9月至2008年8月期间，尼泊尔沙希德·甘加拉尔国家心脏中心（SGNHC）共进行了452例经皮冠状动脉介入治疗（PCI）。其中，仅16例（3.5%）AMI并发心源性休克患者接受了直接PCI（PPCI）。
结果
本研究显示，住院死亡率为50%（n = 8）。在接受PPCI且存活的心源性休克患者中，50%（n = 8）的患者中，6例患者接受了12个月以上的常规随访，2例患者在随后的6个月情况良好，但之后未进行随访。
结论
AMI并发心源性休克患者进行直接PCI可降低死亡率并改善预后。高成本、高住院死亡率和缺乏专业人员是主要限制因素。
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