摘要
目的:探讨主动脉内球囊反搏对心肌梗死心力衰竭的效果及对脑尿钠肽和血清肌酐的影响。方法:选取本院心血管中心科收治的急性心肌梗死合并心力衰竭患者92例,随机分为两组,其中对照组46例,实验组46例,两组均予以卧床休息、吸氧、抗凝、抗心律失常等常规治疗,对照组予以多巴胺治疗,若升压不理想,病情无好转甚至恶化者改用主动脉内球囊反搏(IABP)治疗,实验组在常规治疗的基础上使用IABP治疗。治疗结束后,对比治疗前后患者血流动力学参数、血脑纳肽(BNP)、血肌酐(Cr)、血浆白蛋白、超敏C-反应蛋白(hs-CRP)及两组住院病死率和左心室射血分数。结果:(1)治疗后两组血流动力学参数均有所改善,且实验组血流动力学参数较对照组明显上升,差异有统计学意义(P<0.05);(2)治疗后两组BNP、Cr、血浆白蛋白、Hs-CRP均有所改善,且实验组BNP、Cr、Hs-CRP明显低于对照组,血浆白蛋白明显高于对照组,差异均有统计学意义(P<0.05);(3)实验组住院病死率明显低于对照组,差异有统计学意义(P<0.05);(4)两组治疗后左心室射血分数有所提升,但实验组治疗后24h及出院时左心室射血分数明显高于对照组,差异有统计学意义(P<0.05)。结论:IABP能够明显改善急性心肌梗死心力衰竭患者血流动力学参数,降低血脑BNP、Cr、水平,有效纠正心力衰竭,提高由于心肌梗死导致心力衰竭的存活率,对临床具有指导意义,值得临床推广。
Objective; To investigate the effects of aortic balloon counterpulsation on myocardial infarction, heart failure and its impact on urinary sodium and serum creatinine. Methods.. A total of 92 patients with acute myocardial infarction complicating with heart failure were randomly divided into observation group （n= 46 cases） and control group （n=46 cases）. Both groups were patients were required to stay in bed, given oxygen inhalation, anti-coagulation, anti-arrhythmia treatment and other conventional therapy. The control group was given dopamine, if blood pressure was not promoted well, then intraaortic balloon counterpulsation （IABP） treatment was appliedl while the observation group was given IABP treatment directly based on conventional treatment. After the treatment, hemodynamic parameters, BNP, Cr, plasma-albumin, hs-CRP, fatality rate during hospitalization, and left ventricular ejection fraction of both groups were compared. Results：（1） After treatment, he- modynamic parameters in both groups were improved in both groups, and the hemodynamic parameters of the observation group was higher than that of the control group （P〈0.05） ; （2） After treatment, BNP, Cr, hs-CRP of the observation groupwas significant lower than that of the control group, but , plasma-albumin level was significant higher than that of the control group （P〈0.05） ; （3） In-hospital mortality of the experimental group was significant lower than that of the control group （P d0.05） ;（4） After treatment, left ventricular ejection fraction of both groups were elevated, but 24 hours after treatment, the left ventricular ejection fraction of the observation group was significantly higher than that of the control group （P〈0. 05）. Conclusion： IABP can significantly improve the hemodynamie parameters in patients with acute myocardial infarction complica- ting with heart failure, it can decrease BNP, Cr, plasma-albumin, hs-CRP; correct heart failure, and increase patients＇ survival rate.
出处
《海南医学院学报》
CAS
2015年第2期169-171,174,共4页
Journal of Hainan Medical University
基金
肇庆市科技计划项目(2014-12)~~
关键词
主动脉内球囊反搏
心肌梗死
心力衰竭
脑尿钠肽
血清肌酐
Aortic balloon counterpulsation
Myocardial infarction
Heart failure
Brain urine sodium peptide
Serum ereatinine
