《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (01): 79-81.

• 临床研究 • 上一篇    下一篇

主动脉球囊反搏在急性心肌梗死患者中的运用及预后因素分析

杨俊杰;刘宏斌;丁胜华;李轶   

  1. 解放军总医院心内科，北京市 100853
  • 收稿日期:2008-10-13 出版日期:2009-01-01 发布日期:2009-01-01
  • 通讯作者: 刘宏斌

Application and Prognosis of Intra-Aortic Balloon Pump for Patients with Acute Myocardial Infarction

YANG Jun-jie, LIU Hong-bin, DING Sheng-hua, et al   

  1. Department of Cardioloy, General Hospital of PLA, Beijing 100853, China
  • Received:2008-10-13 Published:2009-01-01 Online:2009-01-01

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被引次数

31

摘要： 目的 分析主动脉球囊反搏（IABP）在急性心肌梗死患者中的运用情况，研究影响其效果的因素。方法 对88例行主动脉球囊反搏的急性心肌梗死患者进行回顾性分析。结果 患者总生存率为54.5%，而经皮冠状动脉介入（PCI）干预下的生存率为59.9%；伴心源性休克或其他高危因素患者的生存率分别为31.6%和72.5%。IABP在保守治疗中的使用时间较高。C反应蛋白（CRP）升高、肺部感染、肾功能不全、室壁运动异常在各自亚组中的危险相关性（OR值）均较高（P<0.05）。冠脉病变类型、肾功能、心功能、上机前平均动脉压可以影响IABP脱机时间。结论 IABP可以安全地在急性心肌梗死高危因素患者中使用，但死亡率仍然较高，且使用时间受冠脉病变类型、肾功能等多种因素影响。

关键词: 主动脉球囊反搏, 心肌梗死, 预后

Abstract: Objective To investigate the prognosis of the intra-aortic balloon pump (IABP) used for patients with acute myocardial infarction and to the risk factors. Methods 88 patients accepted IABP were analyzed retrospectively. Results In spite of overall survival rate (54.5%), under circumstances of percutaneous coronary intervention (PCI), survival rate could reached to 59.9%, with 31.6% and 72.5% in cardiogenic shock group and high-risk group respectively. The time of IABP application increased in drug group. Multivariate Logistic Regression Analysis demonstrated independent-predictor effects of C-reactive protein (CRP), pulmonary infection, renal dysfunction, and wall motion disorder. Moreover, type of coronary artery disease (CAD), renal function, ejection fraction and pre-IABP mean arterial blood pressure could influence the time of IABP application. Conclusion In view of safety, IABP could be used to provide circulatory support for patients with very high risk as well as with cardiogenic shock. Application of IABP could hardly improve in-hospital mortality, and the time of IABP-using could be influenced by many clinical factors, such as type of CAD, renal dysfunction, etc.

Key words: intra-aortic balloon pump (IABP), myocardial infarction, prognosis