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目的评价主动脉内气囊反搏术(IABP)在失去急诊经皮冠状动脉介入(PCI)的急性大面积ST段抬高型心肌梗死(STEMI)患者PCI术前尽早应用的临床疗效。方法 150例发病12～72h之间的STEMI患者,随机分为2组,试验组72例,对照组78例,两组患者入院后均给予规范的药物治疗,试验组在规范药物治疗的基础上尽早床旁应用IABP。两组均于入院10-14d后行冠脉造影必要时PCI术,观察术后4周心功能、左心室及左心房大小、左心室射血分数(Left ventricle ejection fraction,LVEF)及主要不良心脏事件(MACE)的发生情况。结果两组PCI术后4周MACE事件的发生率、LVEF、临床心功能差异均有统计学意义(P﹤0.05)。结论对于大面积STEMI患者择期行PCI,尽早床旁应用IABP能改善心功能,减少MACE事件的发生率,临床应用安全可行,对近期预后是有利的。
Objective To evaluate the clinical efficacy of intra-aortic balloon pump (IABP) as early as possible before PCI in patients with acute massive ST-segment elevation myocardial infarction (STEMI) without emergency percutaneous coronary intervention (PCI). Methods A total of 150 patients with STEMI who developed between 12 and 72 hours were randomly divided into 2 groups: 72 in the experimental group and 78 in the control group. Both groups were given standard medical treatment after admission. On the basis of standard medical treatment, Apply bedside IABP as soon as possible. Coronary angiography was performed 10 to 14 days after admission. PCI was performed as necessary to observe cardiac function, left ventricular and left atrium size, left ventricular ejection fraction (LVEF) and major adverse cardiac The occurrence of an event (MACE). Results The incidences of MACE, LVEF and clinical cardiac function at 4 weeks after PCI were statistically significant (P <0.05). Conclusions For patients with large STEMI who underwent scheduled PCI, IABP at the bedside can improve cardiac function and reduce the incidence of MACE events. The clinical application is safe and feasible, which is beneficial to the short-term prognosis.