文章摘要
冯克福,余晓凡,余华,陈鸿武,周俊岭,马礼坤.主动脉内球囊反搏辅助治疗急性冠脉综合征伴严重心力衰竭患者的预后[J].中国临床保健杂志,2018,21(6):789-793.
主动脉内球囊反搏辅助治疗急性冠脉综合征伴严重心力衰竭患者的预后
The prognostic analysis for patients suffered acute coronary syndrom with severe heart failure who were treated with PCI supported by intra-aortic balloon pump
投稿时间:2018-09-12  
DOI:10.3969/J.issn.1672-6790.2018.06.017
中文关键词: 急性冠状动脉综合征  经皮冠状动脉介入治疗  心力衰竭  危险因素
英文关键词: Acute coronary syndrome  Percutaneous coronary intervention  Heart failure  Risk factors 〖FL
基金项目:安徽省科技攻关计划(1604a0802074);安徽省公益性技术应用研究联动计划(15011d04032)
作者单位E-mail
冯克福 中国科学技术大学附属第一医院安徽省立医院 心血管内科,合肥 230001 lkma119@163.com 
余晓凡 中国科学技术大学附属第一医院安徽省立医院 心血管内科,合肥 230001 lkma119@163.com 
余华 中国科学技术大学附属第一医院安徽省立医院 心血管内科,合肥 230001 lkma119@163.com 
陈鸿武 中国科学技术大学附属第一医院安徽省立医院 心血管内科,合肥 230001 lkma119@163.com 
周俊岭 中国科学技术大学附属第一医院安徽省立医院 心血管内科,合肥 230001 lkma119@163.com 
马礼坤 中国科学技术大学附属第一医院安徽省立医院 心血管内科,合肥 230001 lkma119@163.com 
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中文摘要:
      目的 探讨主动脉内球囊反搏(IABP)辅助经皮冠状动脉介入(PCI)治疗急性冠脉综合征(ACS)伴严重心力衰竭患者的临床特征和影响患者预后的相关因素。方法 回顾性分析2011年1月至2017年6月因ACS伴严重心力衰竭并接受IABP辅助PCI治疗患者192例,收集患者的临床资料、冠脉造影显示的血管病变特征和介入治疗结果,随访患者术后1年内存活情况,根据患者临床转归分为存活组(136例)和死亡组(56例),比较两组患者的临床特点,并分析影响患者预后的相关因素。结果 两组患者在性别、吸烟、高血压病、糖尿病、高脂血症、急性冠脉综合征的类型和发病至PCI时间等方面比较差异无统计学意义(P>0.05);死亡组患者年龄、入院时血肌酐(Cr)水平、心肌坏死标志物(血清肌钙蛋白Ⅰ)水平和心功能4级的比例高于存活组,差异有统计学意义(P<0.05)。进一步采用多因素logistic回归分析发现术前心功能4级、“罪犯”血管为左主干(LM)、术中发生无复流和术后心肌梗死溶栓试验(TIMI)血流<3级是急性冠脉综合征伴严重心力衰竭患者术后1年死亡的危险因素。结论 需主动脉内球囊反搏辅助治疗的急性冠脉综合征伴严重心力衰竭患者,术前心功能4级、“罪犯”血管为左主干、术中发生无复流和术后TIMI血流<3级是影响患者预后的危险因素。
英文摘要:
      Objective To analyze the clinical features and related factors for patients suffered acute coronary syndrom(ACS) with sever heart failure supported by IABP and PCI.Methods A retrospective study was performed on 192 cases of patients suffered ACS with sever hear failure who were admitted and treated with percutaneous coronary intervention (PCI) supported by intra-aortic balloon pump (IABP) from January 2011 to June 2017.We collected detailed information of clinical and angiographic characteristics,clinical outcomes for all patients.According to the clinical outcomes,patients were divided into survival group and death group,All patients were followed up about survival for one year.Results There were no significant difference between the two groups in gender,diabetes,hypertension,hyperlipemia,the type of ACS,the time of symptom onset-to-PCI and blood flow before PCI.Significant differences in age,serum creatinine and cTnI,heart funtion before PCI,culprit vessel on left main and left anterior descending,the number of coronary lesions,no reflow during operation,blood flow after PCI,complete construction were observed between two groups(P<0.05).Multi-factors logistic regression analysis showed grade 4 of heart funtion before PCI,culprit vessel on left main,no reflow during operation and less than TIMI 3 blood flow after PCI were associated with incresed 1-year mortality.Conclusion Grade 4 of heart funtion before PCI,culprit vessel on left main,no reflow during operation and less than TIMI 3 blood flow after PCI are associated with incresed 1-year mortality.For patients of ACS with sever heart failure who were admitted and treated with PCI supported by IABP.
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