IABP联合PCI治疗STEMI合并心源性休克的多因素回顾性分析

王东方; 刘智慧; 王宇楠; 孙百峰; 吴志刚; 孙显东

doi:10.13201/j.issn.1001-1439.2019.12.014

IABP联合PCI治疗STEMI合并心源性休克的多因素回顾性分析

- 内蒙古赤峰市医院心内科(内蒙古赤峰, 024000)

详细信息

通讯作者: 刘智慧,E-mail:liuzhihui0312@163.com

中图分类号: R541.4

收稿日期: 2019-01-15

Retrospective analysis of IABP combined with PCI in the treatment of STEMI with cardiogenic shock

- Department of Cardiology, Chifeng Hospital of Inner Mongolia, Chifeng, Inner Mongolia, 024000, China

More Information

Corresponding author: LIU Zhihui, E-mail: liuzhihui0312@163.com

Received Date: 15 January 2019

摘要

摘要: 目的:回顾性分析应用主动脉内球囊反搏(IABP)联合经皮冠状动脉介入(PCI)治疗ST段抬高型心肌梗死(STEMI)合并心源性休克(CS)患者的30 d病死率。方法:纳入2011-03-2018-04在赤峰市医院心内科接受治疗的STEMI合并CS患者184例,其中100例患者直接行PCI治疗(对照组),84例患者应用IABP联合PCI治疗(IABP组)。观察患者预后,并分析30 d病死率的影响因素。结果:IABP组中,78例患者PCI成功,PCI成功率为92.86%;IABP置入成功率100%,30 d病死率显著低于对照组(38.1%∶62.0%,P<0.05)。多因素Logistic回归分析显示,PCI术后应用时机、发病到入院时间在24 h以上、吸烟、术前血钾异常、术前白细胞异常、术前肌酸激酶同工酶(CK-MB)异常是IABP辅助PCI治疗STEMI合并CS患者30 d病死的高危因素。结论:IABP可以降低STEMI合并CS患者的短期病死率,患者30 d病死率与PCI术后应用时机、发病到入院时间在24 h以上、吸烟、术前血钾异常、术前白细胞异常、术前CK-MB异常密切相关。
- 主动脉内球囊反搏 /
- ST段抬高型心肌梗死 /
- 经皮冠状动脉介入 /
- 心源性休克
Abstract: Objective:To investigate the 30-day mortality in patients with ST-segment elevation myocardial infarction(STEMI) and cardiogenic shock(CS) who treated with intra-aortic balloon pump(IABP) combined with percutaneous coronary intervention(PCI).Method:A total of 184 patients with STEMI and CS in the Department of Cardiology of Chifeng Hospital from March 2011 to April 2018 were enrolled,of whom 100 patients were treated with primary PCI(control group),and 84 patients were treated with IABP and PCI(IABP group).The prognosis of all patients was observed and the influencing factors of 30-day mortality were analyzed.Result:In IABP group,the success rate of PCI was 92.86%(n=78) and the success rate of IABP implantation was 100%(n=84). In addition, 30-day mortality rate was significantly lower in the IABP group than that in the control group(38.1% vs 62.0%,P<0.05).Multivariate Logistic regression analysis showed that risk factors of 30-day mortality included the application time after PCI,the time from onset to admission over 24 hours,smoking,preoperative blood potassium abnormality,preoperative leukocyte abnormality,and preoperative creatine kinase isoenzyme(CK-MB) abnormality in patients with STEMI and CS treated with IABP and PCI.Conclusion:IABP can reduce the short-term mortality in STEMI patients with CS. Thirty-day motality is closely related to the application time after PCI,the time from onset to admission over 24 hours,smoking,preoperative blood potassium abnormality,preoperative leukocyte abnormality,and preoperative creatine kinase isoenzyme(CK-MB) abnormality.
- intra-aortic balloon pump /
- ST-elevation myocardial infarction /
- percutaneous coronary intervention /
- cardiogenic shock

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