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目的:研究急性大面积ST段抬高型心肌梗死(STEMI)患者在择期经皮冠状动脉介入治疗(PCI)前尽早床旁应用主动脉内气囊反搏术(IABP)对预后的观察。方法:选取发病12～72h的STEMI患者150例,随机分为2组,IABP组72例,对照组78例,2组均给予规范的药物治疗,IABP组同时床旁应用IABP。2组均于发病10～14d行冠脉造影,必要时行PCI术,评价梗死相关血管PCI术前及术后冠脉血流,术后4周心功能、IABP主要不良心脏事件的发生情况。结果:2组患者PCI术前TIMI血流、PCI术后4周主要不良心脏事件的发生率、左心室射血分数(LVEF)均有显著性差异(P<0.05)。结论:对于急性大面积STEMI患者择期行PCI,尽早床旁应用IABP能改善梗死相关血管的TIMI血流,改善心功能,减少主要不良心脏事件的发生率,临床应用安全可行。
OBJECTIVE: To investigate the prognostic significance of intra-aortic balloon-patency (IABP) at bedside in patients with acute large-area ST-segment elevation myocardial infarction (STEMI) as early as possible after percutaneous coronary intervention (PCI). Methods: A total of 150 STEMI patients aged 12-72h were enrolled in the study. They were randomly divided into two groups: 72 in the IABP group and 78 in the control group. Both groups were given standard medical treatment. The IABP group also applied IABP at the bedside. Coronary angiography was performed 10 to 14 days after onset, and PCI was performed if necessary to evaluate coronary artery blood flow before and after infarction-related vascular PCI. The incidence of cardiac dysfunction and IABP major adverse cardiac events at 4 weeks after operation were evaluated in both groups. Results: There were significant differences in the incidence of major adverse cardiac events and left ventricular ejection fraction (LVEF) between the two groups before PCI for TIMI flow, 4 weeks after PCI (P <0.05). Conclusions: For patients with acute massive STEMI who underwent scheduled PCI, IABP can improve infarction-related TIMI flow, improve cardiac function and reduce the incidence of major adverse cardiac events. It is safe and feasible for clinical application.