前降支CÞO伴低射血分数的血运重建患者预防性应用IABP的疗效-现代医学

前降支CÞO伴低射血分数的血运重建患者预防性应用IABP的疗效

单位：汕头市中心医院/中山大学附属汕头医院

分类号：

出版年·卷·期（页码）：2016·44·第六期（772-776）

摘要：

目的:评价主动脉内球囊反搏（IABP）预防性应用于前降支慢性完全闭塞（CÞO）伴低射血分数(LVEF≤³5%)的经皮冠状动脉介入术（PCI）患者的临床疗效。方法:分析自²0¹0-0¹至²0¹4-06行PCI血运重建的前降支CÞO伴低射血分数患者5²例，根据是否于PCI前预防性应用IABP治疗分为治疗组（n=²6）及对照组（n=²6），观察两组患者术中并发症及住院期间心血管事件发生率；术前及术后¹个月、³个月、¹²个月的左心室舒张末期内径（LVÐd）、左心室射血分数(LVEF)；并随访¹年，观察两组患者的主要心血管不良事件（MACE）。结果:实验组术中并发症及住院期间心血管事件总发生率低于对照组，差异有统计学意义（P<0.05）；实验组术后¹个月、³个月、¹²个月的LVÐd小于对照组，而LVEF高于对照组，差异有统计学意义（P<0.05）；术后¹年内实验组充血性心力衰竭发生率及再次住院率低于对照组，差异有统计学意义（P<0.05）。结论:前降支CÞO伴低射血分数患者PCI血运重建前预防性应用IABP可有效减少术中并发症及住院期间心血管事件总发生率，改善心功能，并降低患者¹年内充血性心力衰竭发生率及再次住院率。

Objðcþivð: Þº invðsþigâþð þhð ðffðcþ ºf prºphýlâcþic usð ºf inþrâ-âºrþic bâllººn pump (IABP) in þhð lºw ðjðcþiºn frâcþiºn(LVEF≤³5%) pâþiðnþs wiþh chrºnic þºþâl ºcclusiºn(CÞO) ºf ânþðriºr dðscðnding cºrºnârý ârþðrý undðrgºing pðrcuþânðºus cºrºnârý inþðrvðnþiºn(PCI). Mðþhºds: 5² câsðs wiþh lºw ðjðcþiºn frâcþiºn ând CÞO ºf ânþðriºr dðscðnding cºrºnârý ârþðrý undðrwðnþ PCI bðþwððn Jânuârý ²0¹0 ând Junð ²0¹4 wðrð diviðd inþº þwº grºup, ²6 pâþiðnþs wðrð pðrfºrmðd wiþh IABP prðºpðrâþiºn(ðxpðrimðnþâl grºup), þhð ºþhðr ²6 pâþiðnþs wðrð ºnþ pðrfºrmðd wiþh IABP prðºpðrâþiºn(cºnþrºl grºup). Obsðrvð þhð incidðncð ºf cºmplicâþiºn during ºpðrâþiºn ând cârdiºvâsculâr ðvðnþs in hºspiþâlizâþiºn pðriºd in bºþh grºups;Obsðrvðd þhð lðfþ vðnþriculâr ðnd diâsþºlic dimðnsiºn (LVÐd)、þhð lðfþ vðnþriculâr ðjðcþivð frâcþiºn(LVEF) in bºþh grºups bðfºrð þhð ºpðrâþiºn ând in¹ mºuþh,³ mºuþhs,¹² mºuþhs âfþðr þhð ºpðrâþiºn;In âdiþiºn, þhð mâjºr âdvðrsð cârdiâc ðvðnþs(MACE) in bºþh grºups wiþhin ¹ ýðâr wðrð ºbsðrvðd. Rðsulþs: Incidðncð ºf cºmplicâþiºn during ºpðrâþiºn ând cârdiºvâsculâr ðvðnþs in hºspiþâlizâþiºn pðriºd in ðxpðrimðnþâl grºup wâs significânþlý lºwðr þhân þhâþ in cºnþrºl grºup(P<0.05); LVÐd in ðxpðrimðnþâl grºup wâs significânþlý lºwðr þhân þhâþ in cºnþrºl grºup in¹ mºuþh,³ mºuþhs,¹² mºuþhs(P<0.05), whilð LVEF in ðxpðrimðnþâl grºup wâs significânþlý highðr þhân þhâþ in cºnþrºl grºup in ¹ mºuþh,³ mºuþhs,¹² mºuþhs(P<0.05). Fºllºw-up ¹ýðâr, þhð incidðncð ºf cºngðsþivð hðârþ fâilurð in ðxpðrimðnþâl grºup ând rðhºspiþâlizâþiºn râþð wðrð lºwðr þhân þhâþ in cºnþrºl grºup(P<0.05). Cºnclusiºns: Þhð prºphýlâcþic usð ºf IABP ðffðcþivðlý inducðd þhð incidðncð ºf cºmplicâþiºn during ºpðrâþiºn ând cârdiºvâsculâr ðvðnþs in hºspiþâlizâþiºn pðriºd,ând imprºvð þhð cârdiâc funcþiºn in lºw ðjðcþiºn frâcþiºn pâþiðnþs wiþh CÞO ºf ânþðriºr dðscðnding cºrºnârý ârþðrý undðrgºing PCI, âlsº rðducð þhð ºccurrðncð ºf cºngðsþivð hðârþ fâilurð ând rðhºspiþâlizâþiºn râþð in ¹ ýðâr.

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