主动脉内球囊反搏对急性ST段抬高型心肌梗死患者死亡率的影响

发布时间：2018-05-30 09:17

本文选题：心肌梗死 + 反搏动术　；参考：《解放军医学杂志》2016年06期

【摘要】：目的评价急性ST段抬高型心肌梗死(STEMI)患者在主动脉内球囊反搏(IABP)辅助下进行介入治疗的安全性及临床疗效。方法回顾性分析全军医院心血管介入诊疗管理系统中的资料。选取接受急诊PCI的8878例STEMI患者为研究对象,按是否接受IABP治疗分为IABP组(732例)和对照组(8146例)。对两组的基线资料进行对比分析。采用倾向配对分析对IABP组和对照组进行1:1倾向匹配,分析两组术中死亡、院内死亡、支架内血栓、出血等情况的差异。结果二元logistic回归分析显示,年龄、心力衰竭、肾功能不全是院内死亡的危险因素;通过1:1倾向匹配分析,发现两组术中死亡率、术后出血发生率、支架内血栓发生率差异均无统计学意义(P0.05),而IABP组的院内死亡率明显高于对照组(10.4%vs 2.5%,P0.05)。结论 IABP不能降低接受急诊介入治疗的STEMI患者的院内死亡率。
[Abstract]:Objective to evaluate the safety and clinical efficacy of interventional therapy in patients with acute ST-segment elevation myocardial infarction (STEMI) with IABP- assisted intra aortic balloon counterpulsation. Methods the data of cardiovascular interventional management system in military hospital were analyzed retrospectively. 8878 patients with STEMI who received emergency PCI were divided into IABP group (n = 732) and control group (n = 8146) according to whether they received IABP treatment or not. The baseline data of the two groups were compared and analyzed. The 1:1 propensity matching between IABP group and control group was carried out by propensity pairing analysis. The difference of death, hospital death, stent thrombus and hemorrhage between the two groups was analyzed. Results Two-dimensional logistic regression analysis showed that age, heart failure and renal insufficiency were the risk factors of hospital mortality. There was no significant difference in the incidence of thrombus in stents, but the in-hospital mortality in IABP group was significantly higher than that in control group (10.4 vs 2.5, P 0.05). Conclusion IABP can not reduce the hospital mortality of STEMI patients undergoing emergency interventional therapy.
【作者单位】：沈阳军区总医院心血管内科;解放军306医院心血管内科;武警总医院心血管内科;海军总医院心血管内科;兰州军区乌鲁木齐总医院心血管内科;第四军医大学唐都医院心血管内科;陕西武警总队医院心血管内科;解放军91医院心血管内科;第三军医大学大坪医院心血管内科;第三军医大学西南医院心血管内科;解放军97医院心血管内科;解放军451医院心血管内科;南京军区福州总医院心血管内科;第二军医大学长征医院心血管内科;解放军210医院心血管内科;解放军101医院心血管内科;解放军264医院心血管内科;
【分类号】：R542.22

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