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|本期目录/Table of Contents|

预防性应用IABP治疗高危冠心病的有效性和安全性

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第6期
页码:
659-661679
栏目:
临床研究
出版日期:
2014-06-25

文章信息/Info

Title:
Safety and efficacy of prophylactic intra-aortic balloon pump in treatment of high-risk coronary artery disease
作者:
李文华; 何国平; 李 勇; 徐 波; 肖建强; 顾 君; 季建国
(常州市武进人民医院心血管内科，江苏 常州 213002)
Author(s):
LI Wen-hua;  HE Guo-ping;  LI Yong;  XU Bo;  XIAO Jian-qiang;  GU Jun;  JI Jian-guo
(Department of Cardiology, Wujin People’s Hospital, Changzhou 213002, Jiangsu, China)
关键词:
经主动脉内球囊反搏; 冠状动脉疾病; 主要不良心血管事件; 心力衰竭; 心源性休克
Keywords:
intra-aortic ballon pump;  coronary disease;  major adverse cardiovascular events;  heart failure;  cardiac shock
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:观察高危冠心病患者预防性应用经主动脉内球囊反搏（IABP）治疗的有效性和安全性。方法： 入选符合高危冠心病患者59例，分为IABP组（预防性使用IABP，n=23）和非IABP组（未使用或被动型使用IABP，n=36），IABP组PCI前常规预防性的植入IABP，非IABP组未植入IABP或因病情恶化被动性植入IABP。术中术后观察指标：①IABP相关的并发症（血小板下降、贫血、下肢栓塞、坠积性肺炎等）；②恶性心律失常、心力衰竭、心源性休克的发生率；③1年内主要不良心血管事件（MACE）发生率。结果： IABP组贫血和坠积性肺炎或栓塞的发生率显著高于非IABP组（P<0.05），两组血小板下降的比例无明显差异；IABP组发生心力衰竭、心源性休克和恶性心律失常的比例显著低于非IABP组（P<0.05）；两组再发心绞痛或非致死性心肌梗死和再次血运重建发生率无显著差异，IABP组1年内病死率显著低于非IABP组（P<0.05）。结论： 高危冠心病患者预防性应用IABP能有效地改善血流动力学，增加冠脉灌注，减少心力衰竭、恶性心律失常和心源性休克的发生，提高了高危冠心病患者1年的存活率，且并未发生与IABP植入相关的严重并发症。
Abstract:
AIM:To evaluate the efficacy and safety of prophylactic intra-aortic balloon pump (IABP) in the treatment of high-risk coronary artery disease (CAD). METHODS: Fifty-nine patients with high risk CAD were divided into two groups: trial group (prophylactic IABP, n=23) and control group (non-prophylactic IABP, n=36). IABP related complications, incidences of malignant arrhythmias, heart failure and cardiac shock, and incidence of major adverse cardiovascular events (MACE) were observed. RESULTS: In the IABP group and control group, no significant changes were observed in thrombocytopenia. The incidences of anemia, hypostatic pneumonia and embolism in the IABP group were significantly higher than those in non-IABP group (P<0.05) and the incidences of heart failure, cardiac shock and malignant arrhythmias in the IABP group were lower than those in non-IABP group (P<0.05). The death rate within a year in the IABP group was significantly lower than that in the non-IABP group (P<0.05). CONCLUSION: Prophylactic IABP in the treatment of high-risk CAD patients effectively improves hemodynamics, coronary perfusion and left ventricular functions and reduces the occurrence of heart failure, malignant arrhythmias and cardiac shock and thus significantly improves the survival rate within a year. IABP is one of the best assistive devices in the treatment of high-risk CAD patients.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2014-05-05.通讯作者：何国平，主任医师,主要从事冠心病介入诊治研究Email：guopinghe6@sina.com
作者简介：李文华，主治医师，硕士Email：64641233@qq.com
更新日期/Last Update: 2014-07-10