主动脉内球囊反搏在急性心肌梗死急诊PCI术后无血流现象中的应用

目的：探讨主动脉内球囊反搏（IABP）在急性心肌梗死（AMI）急诊冠脉介入术（PCI）后无复流现象（NR）中的治疗作用。方法：分析自2006年1月至2009年12月因急性心肌梗死（AMI）行PCI术后无血流患者22例资料,采用随机分组方法将其中12例运用IABP治疗,其余10例为对照组,观察术后10天内心肌损伤标志物、脑钠肽（BNP）恢复情况,心肌损伤标志物包括肌红蛋白（MYO）,肌酸激酶同工酶（CK-MB）,肌钙蛋白（ICTNI）;治疗10天后应用彩色超声心动图测量患者左房内径、左室内径、左室射血分数（LVEF）;并随访3个月、6个月左房内径、左室内径、左室射血分数（LVEF）变化情况。结果：IABP治疗组患者心肌损伤标志物指标时间-浓度曲线显示指标下降明显快于对照组,与对照组相比差别有统计学意义（P〈0.05）;IABP组BNP峰值较对照组提前,IABP治疗组BNP指标时间-浓度曲线显示指标下降明显快于对照组,与对照组相比差别无统计学意义（P〉0.05）;超声心动图测量两组患者10天、3个月及6个月时左房内径、左室内径差别及LVEF差别有统计学意义（P〈0.05）。结论：IABP能够加速降低AMI急诊PCI术后发生无复流现象患者升高心肌损伤标志物的水平;使BNP峰值提前并改善10天、3个月及6个月时左房内径、左室内径及EF值对心功能具有一定的改善作用。

Application of Intraaortic Balloon Pumping in No-reflow Phenomenonin Emergency Percutaneous Coronary Intervention

Objective：To investigate the effect of Intra-aortic balloon pumping（IABP） on no-reflow phenomenon in emergency Percutaneous Coronary Intervention（PCI）.Methods：Clinical data of 22 acute myocardial infarction patients after PCI with angiographic no-reflow phenomenon were retrospectively analyzed between January 2006 and December 2009.12patients were performed IABP,other 10 patients as control group.Observed difference of cardiac structure,brain natriuretic peptide and cardiac ventricle systolic function between two group,cardiac injury markers（MYO,CK-MB,cTnI） in both groups on the days of 1,2,3,5 7,10 after the different interven-tions.In addition,cardiac structure and cardiac ventricle systolic function including Left Atrium Medial Diameter（LAMD）,Left Ventricu-lar Medial Diameter（LVMD）,Left Ventricular Ejection Fraction（LVEF） was evaluated after 10 days,3 months,6 months.Finally,statis-tics was token to analysis the data.Results：The cardiac injury markers and LAMD,LVMD,LVEF of 10 days,3 months,6 months of IABP group is significant difference control group（P〈0.05）.BNP targets of IABP group compared with the control group no significant difference（P〉0.05）.Conclusions：IABP had effects on prognosis in AMI patients who perform PCI with angiographic no-reflow phe-nomenon.