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目的研究择期行经皮冠状动脉介入治疗(PCI)的大面积急性ST段抬高型心肌梗死(STEMI)患者早期应用主动脉内气囊反搏术(IABP)对临床预后的影响。方法选取发病12～72 h的STEMI患者100例,随机分为两组,IABP组52例、对照组48例,对照组给予规范的药物治疗,IABP组在规范药物治疗的基础上床旁应用IABP 3～5 d。两组均于10～14 d后行冠脉造影及PCI术。评价梗死相关血管PCI术前及术后冠脉血流(TIMI)和术后4周心功能及主要不良心脏事件的发生情况。结果 IABP组PCI术前、术后TIMIⅢ级高于对照组,PCI术后4周主要不良心脏事件的发生率低于对照组,左心室射血分数高于对照组,P均<0.05。结论对于大面积STEMI患者择期行PCI,早期应用IABP能改善梗死相关血管的TIMI血流,减少术后4周主要不良心脏事件的发生率,改善心功能,临床应用安全有效。
Objective To investigate the effect of intra-aortic balloon catheterization (IABP) on clinical prognosis in patients with extensive acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) undergoing elective PCI. Methods A total of 100 STEMI patients with onset of 12 ~ 72 h were randomly divided into two groups: IABP group (n = 52) and control group (n = 48). The control group was given standard drug therapy. The IABP group was given bedside application of IABP 3 ~ 5 d. Both groups underwent coronary angiography and PCI at 10 to 14 days. To evaluate the occurrence of cardiac function and major adverse cardiac events before and after coronary intervention (PCI) and coronary angiography (TIMI) and postoperative 4 weeks. Results The TIMI Ⅲ level in the IABP group was significantly higher than that in the control group before PCI. The incidence of major adverse cardiac events at 4 weeks after PCI was lower in the IABP group than in the control group, and the left ventricular ejection fraction was significantly higher than that in the control group (all P <0.05). Conclusions For patients with extensive STEMI who underwent PCI at an early stage, early application of IABP can improve the TIMI blood flow in the infarct-related vessels, reduce the incidence of major adverse cardiac events 4 weeks after operation and improve cardiac function, which is safe and effective in clinical application.