摘要
Abstract
Objective To investigate the effect of intra-aortic balloon pumping(IABP)combined with percutaneous coronary intervention(PCI)in the treatment of cardiogenic shock after acute myocardial infarction.Methods Sixty patients with cardiogenic shock after acute myocardial infarction were selected.They were divided into two groups by the random number table method.Patients undergoing PCI treatment were enrolled in the PCI group,while patients receiving a combined therapy of PCI and IABP were assigned to the combination treatment group,with 30 cases in each group.We compared the changes in vital signs,cardiac function,and levels of inflammatory factors and myocardial injury markers before and after treatment,as well as the incidence of adverse cardiovascular events after surgery between the two groups.Results After treatment,the mean arterial pressure in the combination treatment group was significantly higher than that in the PCI group[(104.06±9.79)mmHg vs.(91.27±8.84)mmHg,P<0.01];the heart rate was significantly lower than that of the PCI group[(85.37±8.13)times/min vs.(94.72±8.94)times/min,P<0.01].The peak IL-6 level of patients in the combination treatment group was advanced to 24 hours after surgery,while the combination treatment group exhibited a significantly smaller magnitude of TNF-α elevation compared with the PCI group(P<0.05).In the combination treatment group,the LVEF[(45.27±4.35)%],cardiac output[(5.52±0.77)L/min],and stroke volume[(78.89±7.75)mL]were all significantly higher than those in the PCI group[values of the above indexes were(40.84±3.81)%,(5.01±0.64)L/min,and(71.28±7.03)mL,respectively],while the left ventricular end-diastolic diameter was significantly smaller than that in the PCI group[(50.09±4.87)mm vs.(55.27±5.36)mm,P<0.01].After treatment,the levels of N-terminal B-type natriuretic peptide(NT-proBNP),cardiac troponin and creatine kinase isoenzymes,and the incidence of adverse cardiovascular events in the combination treatment group were all significantly lower than those in the PCI group(all P<0.05).Conclusion The combination of IABP and PCI for treating cardiogenic shock after acute myocardial infarction could significantly improve cardiac function compared with PCI therapy alone,which may be associated with alleviating the inflammatory response in the acute phase of myocardial infarction.关键词
急性心肌梗死/心源性休克/主动脉球囊反搏/经皮冠状动脉介入/炎症因子/心功能Key words
acute myocardial infarction/cardiogenic shock/intra-aortic balloon pumping/percutaneous coronary intervention/inflammatory factor/cardiac function分类
临床医学
