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目的评价急性ST段抬高型心肌梗死(STEMI)患者在主动脉内球囊反搏(IABP)辅助下进行介入治疗的安全性及临床疗效。方法回顾性分析全军医院心血管介入诊疗管理系统中的资料。选取接受急诊PCI的8878例STEMI患者为研究对象,按是否接受IABP治疗分为IABP组(732例)和对照组(8146例)。对两组的基线资料进行对比分析。采用倾向配对分析对IABP组和对照组进行1:1倾向匹配,分析两组术中死亡、院内死亡、支架内血栓、出血等情况的差异。结果二元logistic回归分析显示,年龄、心力衰竭、肾功能不全是院内死亡的危险因素;通过1:1倾向匹配分析,发现两组术中死亡率、术后出血发生率、支架内血栓发生率差异均无统计学意义(P>0.05),而IABP组的院内死亡率明显高于对照组(10.4%vs 2.5%,P<0.05)。结论 IABP不能降低接受急诊介入治疗的STEMI患者的院内死亡率。
Objective To evaluate the safety and clinical efficacy of interventional therapy with the help of intra-aortic balloon pump (IABP) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods Retrospectively analyze the data of Cardiovascular Intervention Management System in PLA hospitals. A total of 8878 STEMI patients undergoing emergency PCI were selected as study subjects and divided into IABP group (732 cases) and control group (8146 cases) according to whether they received IABP or not. The two groups of baseline data for comparative analysis. A propensity-match analysis was used to match the IABP group with that of the control group by a 1: 1 propensity match. The differences in intraoperative death, in-hospital mortality, stent thrombosis, and bleeding were analyzed. Results Binary logistic regression analysis showed that age, heart failure and renal insufficiency were the risk factors of nosocomial death. According to the 1: 1 propensity matching analysis, two groups of intraoperative mortality, incidence of postoperative bleeding, incidence of stent thrombosis (P> 0.05). However, the in-hospital mortality in IABP group was significantly higher than that in control group (10.4% vs 2.5%, P <0.05). Conclusions IABP does not reduce in-hospital mortality in STEMI patients receiving emergency interventions.