论文部分内容阅读
目的:评价急性心肌梗死(AMI)并发心源性休克患者行急诊介入治疗(PCI)时主动脉球囊反搏术(IABP)对术后C反应蛋白(CRP)水平的影响。方法:43例在IABP支持下行急诊PCI的并发心源性休克的AMI患者为IABP组,将同期行急诊PCI但没有行IABP支持的合并心源性休克的AMI患者48例设为对照组;入院后分别测定入院时以及第3天、第7天的CRP水平;比较2组PCI术后TnI峰值,术后2周、3个月的左室射血分数,随访患者术后3个月的病死率。结果:2组患者入院时的CRP水平无明显差异,而第3天、第7天的CRP水平IABP组明显低于对照组[(80.3±42.8)∶(98.9±31.6)mg/L,(70.6±34.3)∶(85.8±25.8)mg/L;均P<0.05];IABP组患者术后TNI峰值明显低于对照组[(21.6±4.1)∶(23.7±4.6)ng/ml,P<0.05],术后2周、3个月的左室射血分数较对照组明显改善[(44.7±7.3)%∶(40.5±6.2)%,(45.1±6.6)%∶(40.7±4.4)%;均P<0.05];而IABP组术后3个月内的病死率明显降低(P<0.05)。结论:对并发心源性休克的AMI患者行急诊PCI术同时采用IABP支持治疗能明显降低术后CRP水平,并能有效地改善左室功能和降低术后3个月内病死率。
Objective: To evaluate the effect of aortic balloon counterpulsation (IABP) on C-reactive protein (CRP) level in patients with acute myocardial infarction (AMI) complicated with cardiogenic shock during emergency interventional therapy (PCI). Methods: Forty-three AMI patients with concurrent cardiogenic shock who underwent emergency PCI with IABP were treated with IABP. Forty-eight AMI patients with cardiogenic shock who underwent emergency PCI during the same period without IABP support were enrolled The levels of CRP on admission and on the third and seventh days were measured respectively. The TnI peak value, the left ventricular ejection fraction at 2 and 3 months after PCI were compared between the two groups, and the patients were followed up for 3 months rate. Results: There was no significant difference in CRP levels between the two groups when compared with those in the control group [(80.3 ± 42.8) :( 98.9 ± 31.6) mg / L and (70.6 ± 34.3) :( 85.8 ± 25.8) mg / L, all P <0.05]. The TNI peak value of postoperative IABP group was significantly lower than that of the control group [(21.6 ± 4.1) vs (23.7 ± 4.6) ng / (44.7 ± 7.3)%: (40.5 ± 6.2)%, (45.1 ± 6.6)%: (40.7 ± 4.4)%, respectively. Compared with the control group, the left ventricular ejection fraction at 2 weeks and 3 months after operation was significantly improved All P <0.05]. However, the mortality rate within 3 months after operation in IABP group was significantly lower (P <0.05). Conclusions: Emergency PCI combined with IABP supportive therapy in patients with AMI complicated with cardiogenic shock can significantly reduce postoperative CRP level, and can effectively improve left ventricular function and reduce mortality within 3 months after operation.