浙江医学Issue(4)：314-318,5.
静脉溶栓治疗对急性心肌梗死致心源性休克患者血流动力学的影响
Effect of intravenous thrombolytic therapy on hemodynamics in acute myocardial infarction patients with cardiac shock
摘要
Abstract
Objective To investigate the effects of thrombolytic therapy on hemodynamics in acute myocardial infarction patients with cardiac shock. Methods Seventy six patients of acute myocardial infarction patients with cardiogenic shock were enrol ed in the study, including 41 patients receiving conventional treatment with intravenous thrombolytic therapy (thrombolysis group) and 35 receiving conventional treatment alone (non- thrombolysis group). Pulse- indicated continous cardiac output (PiC-CO) was performed within 12h of admission, and the mean arterial pressure (MAP), cardiac index (CI), intrathoracic blood volume index(ITBI), extravascular lung water index(EVLWI), stroke volume index (SVI), systemic vascular resistance index (SVRI), global end diastolic volume index(GEDVI) and other parameters were monitored;the central venous pressure (CVP) was also monitored. Plasma B type natriuretic peptide (BNP) and high sensitive C reactive protein (hs- CRP) were measured. Results In 41 patients undergoing thrombolysis, 35 cases were successful and 6 failed. Two cases in thrombolysis group died within 24h of the study;while 10 cases died in nonthrombolysis group: 6 cases died in 24h and 4 cases died in 7d. The CI, SVI, MAP in thrombolysis group were increased and EVLWI, ITBVI, GEDVI, CVP were significantly decreased compared to non- thrombolysis group (P<0.01). Plasma BNP, hs- CRP and the left ventricular end diastolic diameter in thrombolysis group were significantly lower than those in non- thrombolysis group (P<0.01), and left ventricular ejection fraction in thrombolysis group was improved more markedly than that in non- thrombolysis group (P<0.01). Conclusion Thrombolytic therapy with conventional treatment can fur-ther improve hemodynamic index in acute myocardial infarction patients with cardiogenic shock.关键词
急性心肌梗死/心源性休克/血流动力学/静脉溶栓Key words
Acute myocardial infarction/Cardiac shock/Hemodynamics/Intravenous thrombolysis引用本文复制引用
孙燕,赵金龙,王丽琼,周良安,毛小红,何慧虹,唐关敏..静脉溶栓治疗对急性心肌梗死致心源性休克患者血流动力学的影响[J].浙江医学,2014,(4):314-318,5.基金项目
浙江省中医药重点学科经费资助项目（2012- XY- D009）；平湖市科技局资助课题[平科技（2011）19号] （）
