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目的:探讨主动脉内球囊反搏(IABP)在急性心肌梗死(AMI)急诊冠脉介入术(PCI)后无复流现象(NR)中的治疗作用。方法:分析自2006年1月至2009年12月因急性心肌梗死(AMI)行PCI术后无血流患者22例资料,采用随机分组方法将其中12例运用IABP治疗,其余10例为对照组,观察术后10天内心肌损伤标志物、脑钠肽(BNP)恢复情况,心肌损伤标志物包括肌红蛋白(MYO),肌酸激酶同工酶(CK-MB),肌钙蛋白(ICTNI);治疗10天后应用彩色超声心动图测量患者左房内径、左室内径、左室射血分数(LVEF);并随访3个月、6个月左房内径、左室内径、左室射血分数(LVEF)变化情况。结果:IABP治疗组患者心肌损伤标志物指标时间-浓度曲线显示指标下降明显快于对照组,与对照组相比差别有统计学意义(P<0.05);IABP组BNP峰值较对照组提前,IABP治疗组BNP指标时间-浓度曲线显示指标下降明显快于对照组,与对照组相比差别无统计学意义(P>0.05);超声心动图测量两组患者10天、3个月及6个月时左房内径、左室内径差别及LVEF差别有统计学意义(P<0.05)。结论:IABP能够加速降低AMI急诊PCI术后发生无复流现象患者升高心肌损伤标志物的水平;使BNP峰值提前并改善10天、3个月及6个月时左房内径、左室内径及EF值对心功能具有一定的改善作用。
Objective: To explore the therapeutic effect of intra-aortic balloon pump (IABP) on no-reflow phenomenon after acute coronary intervention (PCI) in acute myocardial infarction (AMI). Methods: From January 2006 to December 2009, 22 patients with no blood flow after acute myocardial infarction (AMI) undergoing PCI were analyzed. Twelve of them were treated with IABP by randomization and the remaining 10 patients were treated as control group , Myocardial injury markers and the recovery of BNP were observed within 10 days after operation. Myocardial injury markers included myoglobin (MYO), creatine kinase (CK-MB), troponin (ICTNI) ; Left atrium diameter, left ventricular internal diameter and left ventricular ejection fraction (LVEF) were measured by color echocardiography after 10 days of treatment; and left atrial diameter, left ventricular diameter, left ventricular ejection fraction (LVEF) changes. Results: The time-concentration curve of myocardial injury markers in IABP treatment group showed that the index decreased significantly faster than that of the control group (P <0.05); the peak value of BNP in IABP group was earlier than that of the control group, IABP The time-concentration curve of BNP index in the treatment group showed that the index decreased significantly faster than that of the control group, and there was no significant difference compared with the control group (P> 0.05); echocardiography measured the two groups of patients 10 days, 3 months and 6 months Left atrial diameter, left ventricular diameter difference and LVEF difference was statistically significant (P <0.05). Conclusions: IABP can accelerate the decrease of myocardial injury markers in AMI patients with no-reflow after AMI. Make the peak of BNP advance and improve left atrial diameter, left ventricular diameter at 10, 3 and 6 months And EF value of the heart function has a certain improvement.