中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
11期
1164-1166
,共3页
心肌梗死%休克,心源性%主动脉内气囊泵
心肌梗死%休剋,心源性%主動脈內氣囊泵
심기경사%휴극,심원성%주동맥내기낭빙
Myocardial infarction%Shock,cardiogenic%Intra-aortic balloon pumping
目的 观察主动脉内球囊反搏术(IABP)辅助治疗老年人急性心肌梗死(AMI)合并心源性休克(CS)的临床疗效. 方法 选择2005年4月至2012年10月因AMI并发CS入院的老年患者62例,均行直接经皮冠状动脉血管成形介入术(PCI),根据是否应用IABP分为IABP治疗组32例和对照组30例,其他治疗均相似,分析两组患者血压、心率、心脏指数,及术后即时和术后2周心脏左心室射血分数(LVEF),并比较近期及远期临床疗效. 结果 IABP治疗组较对照组患者24 h的舒张压、平均动脉压、心脏指数明显提高,心率明显下降[(64.4±11.1)mmHg比(37.8±15.1)mmHg、(71.4±8.3)mmHg比(43.0±10.5)mmHg、(2.98±0.33)L· min-1·m-2比(1.99±0.29)L·min-1·m-2、(90.7±18.7)次/min比(130.2±50.1)次/min,t=7.97、11.83、12.51、4.16,均P=0.000](1 mmHg=0.133 kPa);IABP组和对照组患者术后2周LVEF值均较术后即时显著提高,且IABP组患者改善更为显著[(46.4±7.2)％比(39.1±6.8)％,t=3.91,P=0.000];IABP治疗组较对照组比较住院期间死亡人数、远期死亡人数及远期再发心肌梗死人数有所下降,但差异无统计学意义(2例比4例、3例比8例、6例比10例,x2=0.89、3.17、1.72,P=0.346、0.075、0.190). 结论 老年AMI合并CS患者PCI术后联合应用IABP可显著改善患者术后的心功能.
目的 觀察主動脈內毬囊反搏術(IABP)輔助治療老年人急性心肌梗死(AMI)閤併心源性休剋(CS)的臨床療效. 方法 選擇2005年4月至2012年10月因AMI併髮CS入院的老年患者62例,均行直接經皮冠狀動脈血管成形介入術(PCI),根據是否應用IABP分為IABP治療組32例和對照組30例,其他治療均相似,分析兩組患者血壓、心率、心髒指數,及術後即時和術後2週心髒左心室射血分數(LVEF),併比較近期及遠期臨床療效. 結果 IABP治療組較對照組患者24 h的舒張壓、平均動脈壓、心髒指數明顯提高,心率明顯下降[(64.4±11.1)mmHg比(37.8±15.1)mmHg、(71.4±8.3)mmHg比(43.0±10.5)mmHg、(2.98±0.33)L· min-1·m-2比(1.99±0.29)L·min-1·m-2、(90.7±18.7)次/min比(130.2±50.1)次/min,t=7.97、11.83、12.51、4.16,均P=0.000](1 mmHg=0.133 kPa);IABP組和對照組患者術後2週LVEF值均較術後即時顯著提高,且IABP組患者改善更為顯著[(46.4±7.2)％比(39.1±6.8)％,t=3.91,P=0.000];IABP治療組較對照組比較住院期間死亡人數、遠期死亡人數及遠期再髮心肌梗死人數有所下降,但差異無統計學意義(2例比4例、3例比8例、6例比10例,x2=0.89、3.17、1.72,P=0.346、0.075、0.190). 結論 老年AMI閤併CS患者PCI術後聯閤應用IABP可顯著改善患者術後的心功能.
목적 관찰주동맥내구낭반박술(IABP)보조치료노년인급성심기경사(AMI)합병심원성휴극(CS)적림상료효. 방법 선택2005년4월지2012년10월인AMI병발CS입원적노년환자62례,균행직접경피관상동맥혈관성형개입술(PCI),근거시부응용IABP분위IABP치료조32례화대조조30례,기타치료균상사,분석량조환자혈압、심솔、심장지수,급술후즉시화술후2주심장좌심실사혈분수(LVEF),병비교근기급원기림상료효. 결과 IABP치료조교대조조환자24 h적서장압、평균동맥압、심장지수명현제고,심솔명현하강[(64.4±11.1)mmHg비(37.8±15.1)mmHg、(71.4±8.3)mmHg비(43.0±10.5)mmHg、(2.98±0.33)L· min-1·m-2비(1.99±0.29)L·min-1·m-2、(90.7±18.7)차/min비(130.2±50.1)차/min,t=7.97、11.83、12.51、4.16,균P=0.000](1 mmHg=0.133 kPa);IABP조화대조조환자술후2주LVEF치균교술후즉시현저제고,차IABP조환자개선경위현저[(46.4±7.2)％비(39.1±6.8)％,t=3.91,P=0.000];IABP치료조교대조조비교주원기간사망인수、원기사망인수급원기재발심기경사인수유소하강,단차이무통계학의의(2례비4례、3례비8례、6례비10례,x2=0.89、3.17、1.72,P=0.346、0.075、0.190). 결론 노년AMI합병CS환자PCI술후연합응용IABP가현저개선환자술후적심공능.
Objective To evaluate the efficacy of intra-aortic balloon pump (IABP) on elderly patients with acute myocardial infarction (AMI) combined with cardiogenic shock (CS).Methods Among 62 elderly patients with AMI plus CS undergoing percutaneous coronary intervention (PCI),32 patients received IABP before PCI (IABP group) and 30 patients did not (control group).Diastolic blood press ure(DBP),mean arterial pressure (MAP),heart rate,cardiac index (CI),and ejective fraction before and 2 weeks after PCI in the two groups were observed.The short-and long-term therapeutic effects were compared between the two groups.Results The DBP,MAP and CI were higher and heart rate was lower in IABP group than in control group within 24 h after IABP [(64.4± 11.1) mmHg vs.(37.8±15.1) mmHg,(71.4±8.3) mmHg vs.(43.0±10.5) mmHg,(2.98± 0.33) L· min-1 · m-2 vs.(1.99±0.29) L· min-1 · m-2,(90.7±18.7) /min vs.(130.2±50.1)/min,t=7.97,11.83,12.51,4.16,all P=0.000].Two weeks after IABP,LVEF was significantly improved in IABP and control groups as compared with pre-IABP [(46.4±7.2)％ vs.(35.2± 7.2) ％,(39.1±6.8) ％ vs.(33.8±6.7) ％,both P＜0.01],and heart function was improved more significantly in IABP group than in the control group (t=3.91,P=0.000).Death tolls during hospitalization and after leaving hospital,and recurrence of AMI had no significant differences between the two groups (2 cases vs.4 cases,3 cases vs.8 cases,6 cases vs.10 cases,x2 =0.89,3.17,1.72,P=0.346,0.075,0.190).Conclusions IABP can improve the cardiac function in elderly AMI patients with CS after PCI.
