疑难病杂志
疑難病雜誌
의난병잡지
JOURNAL OF DIFFICULT AND COMPLICATED CASES
2014年
4期
358-360,364
,共4页
心肌梗死,急性%休克,心源性%经皮冠状动脉介入术%主动脉内球囊反搏%炎性因子
心肌梗死,急性%休剋,心源性%經皮冠狀動脈介入術%主動脈內毬囊反搏%炎性因子
심기경사,급성%휴극,심원성%경피관상동맥개입술%주동맥내구낭반박%염성인자
Myocardial infarction,acute%Shock,cardiogenic%Percutaneous coronary intervention%Intra-aortic balloon counterpulsation%Inflammatory cytokines
目的:探讨急性心肌梗死(AMI)并发心源性休克患者行急诊经皮冠状动脉介入术(PCI)治疗时主动脉内球囊反搏( IABP)对术后炎性因子水平的影响。方法应用IABP支持下进行急诊PCI治疗的AMI并发心源性休克患者46例为观察组,以同期收治未应用IABP支持下采用急诊PCI治疗的AMI并发心源性休克患者32例为对照组,分别观察患者术前、术后3、7 d时的C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平变化,术前、术后2周、术后3个月时的左心室射血分数( LVEF)变化及患者病死率。结果观察组与对照组在AMI分类、病变位置、病变累及分支及置入支架数方面比较差异无统计学意义( P >0.05),观察组住院时间短于对照组(P <0.05);观察组患者IABP时间平均为(84.12±34.74)h,2组术前CRP、TNF-α、IL-6水平及LVEF比较差异无统计学意义( P >0.05),术后3、7 d时2组CRP、TNF-α、IL-6水平均升高( P <0.05),且观察组明显低于对照组( P <0.05),LVEF术后2周、3个月时观察组明显高于对照组( P <0.05),术后3个月内病死率观察组明显低于对照组(30.43%vs.56.25%, P <0.05)。结论合并心源性休克的AMI患者在急诊行PCI治疗时联合IABP治疗能明显降低术后炎性因子水平,改善左心室功能,降低术后近期病死率。
目的:探討急性心肌梗死(AMI)併髮心源性休剋患者行急診經皮冠狀動脈介入術(PCI)治療時主動脈內毬囊反搏( IABP)對術後炎性因子水平的影響。方法應用IABP支持下進行急診PCI治療的AMI併髮心源性休剋患者46例為觀察組,以同期收治未應用IABP支持下採用急診PCI治療的AMI併髮心源性休剋患者32例為對照組,分彆觀察患者術前、術後3、7 d時的C反應蛋白(CRP)、腫瘤壞死因子-α(TNF-α)、白細胞介素-6(IL-6)水平變化,術前、術後2週、術後3箇月時的左心室射血分數( LVEF)變化及患者病死率。結果觀察組與對照組在AMI分類、病變位置、病變纍及分支及置入支架數方麵比較差異無統計學意義( P >0.05),觀察組住院時間短于對照組(P <0.05);觀察組患者IABP時間平均為(84.12±34.74)h,2組術前CRP、TNF-α、IL-6水平及LVEF比較差異無統計學意義( P >0.05),術後3、7 d時2組CRP、TNF-α、IL-6水平均升高( P <0.05),且觀察組明顯低于對照組( P <0.05),LVEF術後2週、3箇月時觀察組明顯高于對照組( P <0.05),術後3箇月內病死率觀察組明顯低于對照組(30.43%vs.56.25%, P <0.05)。結論閤併心源性休剋的AMI患者在急診行PCI治療時聯閤IABP治療能明顯降低術後炎性因子水平,改善左心室功能,降低術後近期病死率。
목적:탐토급성심기경사(AMI)병발심원성휴극환자행급진경피관상동맥개입술(PCI)치료시주동맥내구낭반박( IABP)대술후염성인자수평적영향。방법응용IABP지지하진행급진PCI치료적AMI병발심원성휴극환자46례위관찰조,이동기수치미응용IABP지지하채용급진PCI치료적AMI병발심원성휴극환자32례위대조조,분별관찰환자술전、술후3、7 d시적C반응단백(CRP)、종류배사인자-α(TNF-α)、백세포개소-6(IL-6)수평변화,술전、술후2주、술후3개월시적좌심실사혈분수( LVEF)변화급환자병사솔。결과관찰조여대조조재AMI분류、병변위치、병변루급분지급치입지가수방면비교차이무통계학의의( P >0.05),관찰조주원시간단우대조조(P <0.05);관찰조환자IABP시간평균위(84.12±34.74)h,2조술전CRP、TNF-α、IL-6수평급LVEF비교차이무통계학의의( P >0.05),술후3、7 d시2조CRP、TNF-α、IL-6수평균승고( P <0.05),차관찰조명현저우대조조( P <0.05),LVEF술후2주、3개월시관찰조명현고우대조조( P <0.05),술후3개월내병사솔관찰조명현저우대조조(30.43%vs.56.25%, P <0.05)。결론합병심원성휴극적AMI환자재급진행PCI치료시연합IABP치료능명현강저술후염성인자수평,개선좌심실공능,강저술후근기병사솔。
Objective To investigate the effect of emergency percutaneous coronary intervention ( PCI)treatment of intra-aortic balloon counterpulsation ( IABP) on the levels of inflammatory factors in postoperative patients with acute myocar -dial infarction ( AMI) complicated by cardiogenic shock .Methods 46 cases of observation group were AMI patients with car-diogenic shock , IABP support for application of emergency PCI for the treatment , during the same period , 32 cases of patients with AMI complicated by cardiogenic shock as the control group did not apply to the use of IABP support received the treat -ment of primary PCI , preoperative , after 3 and 7 d, C-reactive protein ( CRP) , tumor necrosis factor-α( TNF-α) , interleu-kin-6 (IL-6) were observed, preoperative and 2 weeks postoperative, three months after treatment, left ventricular ejection fraction when LVEF changes and patient mortality were observed .Results Observation group and control group in AMI classi-fication, lesion location , number of lesions involving the branches and stent implantation showed relatively no significant difference ( P >0.05), observation group showed shorter hospital stay than the control group ( P <0.05); The patients IABP average of (84.12 ±34.74) h, 2 groups preoperative CRP , TNF-α, IL-6 levels and LVEF was not significant differ-ence ( P >0.05), after 3 and 7 d, 2 groups'CRP, TNF-α, IL-6 levels were elevated ( P <0.05), but the observation group was significantly lower than the control group ( P <0.05), after 2 weeks, 3 months LVEF of the observation group was significantly higher ( P <0.05), mortality within 3 months after treatment, the observation group was significantly lower than the control group (30.43%vs.56.25%, P <0.05).Conclusion AMI patients with cardiogenic shock treated with PCI at the time of the emergency joint IABP therapy can significantly reduce postoperative inflammatory cytokine levels , improve left ventricular function and reduce postoperative mortality .