摘要
观察IABP在未行PCI治疗情况下,是否有增加首发STEMI靶血管再通的作用。方法:回顾性收集首发STEMI患者1052例,其中急诊造影证实极高危病变68例作为试验组,采用三联抗血小板聚集+低分子肝素钠抗凝+IABP治疗。同期纳入拒绝溶栓及急诊PCI治疗50例STEMI为对照组,仅给予三联抗血小板聚集+低分子肝素钠抗凝治疗,两组于心梗后8天择期行冠脉造影检查。结果:(1)试验组闭塞靶血管再通率(84.75%)明显高于对照组(36%),P<0.001;(2)试验组较对照组心功能改善明显,x~2=4.924,P<0.001;(3)试验组BNP水平较对照组明显降低,x~2=14.09,P<0.05。结论:IABP增加STEMI闭塞血管段两端压力阶差,其独特的冲击作用对闭塞血管处松软血栓起到"碎栓"的作用,提高靶血管再通率,且能显著降低院内死亡率。
Objective:To observe the IABP in no PCI treatment cases,whether to have increased STEMI target recanalization.Methods:1052 STEMI cases were retrospectively collected.68 cases were confirmed after Emergency angiography show extremely high-risk lesions as treatment group(triple antiplatelet aggregation + low molecular heparin sodium anticoagulation + IABP).During the same period.There were 50 s STEMI cases whom refused to accept Thrombolysis and Emergency PCI as the control group(triple antiplatelet aggregation + low molecular heparin sodium anticoagulation).After 8 days of AMI period,all of cases accept Coronary Angiography examination.Results:(l)The target recanalization rate of the treatment group(84.75%) was significantly higher than the rate of control group(36%),P < 0.001;(2) The treatment group than control group significantly improved cardiac function,x~2=4.924,P < 0.001;(3) The BNP level was significantly lower in control group,x~2= 14.09,P < 0.05).Conclusion:IABP can increase STEMI pressure difference on both ends of the occluded vessel segment,its unique impact to block blood vessels in spongy thrombosis have the effect of "broken bolt",improve the rate of target vessels,and can significantly reduce the hospital mortality.
引文
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