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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(CTO)伴低射血分数[左心室射血分数(LVEF)≤35%]的经皮冠状动脉介入(PCI)治疗患者的临床疗效。方法:选择2010年1月至2014年6月行PCI血运重建的前降支CTO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、3、12个月的左心室舒张末期内径(LVDd)、LVEF;并随访1年,观察两组患者的主要心血管不良事件(MACE)发生情况。结果:治疗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);治疗组术后1、3、12个月的LVDd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年内治疗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CTO伴低射血分数患者PCI血运重建前预防性应用IABP可有效降低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。
PURPOSE: To evaluate the feasibility of intra-aortic balloon pump (IABP) prophylaxis for percutaneous coronary intervention in patients with anterior descending coronary artery occlusion (CTO) with low ejection fraction [LVEF ≤35%] (PCI) in patients with clinical efficacy. Methods: From January 2010 to June 2014, 52 patients with pre-descending CTO and low ejection fraction (PCI) were enrolled in this study. Patients were divided into treatment group (n = 26) according to prophylactic IABP treatment before PCI, And control group (n = 26). The intraoperative complications and incidence of cardiovascular events during hospital stay were observed. The left ventricular end-diastolic diameter (LVDd), LVEF The patients were followed up for 1 year to observe the occurrence of major cardiovascular adverse events (MACE) in both groups. Results: The intraoperative complications and the total incidence of cardiovascular events during hospitalization were lower in the treatment group than in the control group (P <0.05). The LVDd in the treatment group at 1, 3, and 12 months after operation were lower than those in the control group, While the LVEF was higher than that of the control group (P <0.05). The incidence of congestive heart failure and re-hospitalization rate in the treatment group within 1 year after operation were lower than those in the control group, with significant difference (P <0.05). Conclusion: The prophylactic use of IABP before PCI in patients with CTO and low ejection fraction can effectively reduce the intraoperative complications and the total incidence of cardiovascular events during hospitalization, improve cardiac function, and reduce congestive heart function within one year The incidence of failure and re-hospitalization rate.