| BackgroundAcute myocardial infarction(AMI)with cardiogenic shock(CS)is extremely common in clinic and is the main cause of AMI death.Although percutaneous coronary intervention(PCI)is the main treatment for AMI combined with CS,it is risky and still has a high risk of death.Intra Aortic Ballon Pumping(IABP)has the functions of enhancing coronary blood flow,reducing myocardial oxygen consumption and cardiac afterload.Some studies believe that its combined application with PCI can improve the therapeutic effect of AMI combined with CS and optimize prognosis,but There is insufficient evidence support and it has not been widely used in clinical practice.ObjectiveTo evaluate the efficacy of IABP combined with PCI in the treatment of AMI combined with CS,and to provide a reference for the clinical treatment of AMI combined with CS.MethodsA total of 98 patients with AMI and CS who were treated and treated in our hospital from June 2018 to December 2019 were selected as the research objects,and retrospective research and analysis were carried out.According to the treatment methods,51 cases were treated with PCI and set as the control group;the other 47 cases were treated with IABP after PCI and set as the treatment group.To observe and compare the hemodynamic indexes,Left Ventricular Ejection Fraction(LVEF),N-terminal pro-B natriuretic peptide(NT-pro BNP),and urine output of the two groups of patients,Lactic acid,cardiac troponin I(cardiac troponin I,c Tn I),cardiac troponin T(cardiac troponin T,c Tn T),Creatine KinaseIsoenzyme-MB(CK-MB),clinical efficacy,prognosis Follow-up(30 days and 6 months postoperative mortality,incidence of adverse cardiovascular events,rate of recurrent myocardial infarction),comprehensive evaluation of the application value of IABP combined with PCI.Results1.Before first aid,there was no significant difference in mean arterial pressure(MAP)and heart rate(HR)between the two groups of patients(P>0.05).1h after IABP,the MAP and HR of the treatment group were significantly increased;1d after treatment,the MAP of the treatment group was higher than that of the control group,and HR was lower than that of the control group,the difference was statistically significant(P<0.05);The difference was not statistically significant(P>0.05).2.Before first aid,there was no significant difference in LVEF,NT-pro BNP,urine output,lactic acid,c Tn I,c Tn T,CK-MB between the two groups of patients(P>0.05).One day after treatment,LVEF,NT-pro BNP,and lactic acid in the treatment group were slightly better than those in the control group,but the difference was not statistically significant(P>0.05);the urine output in the treatment group was significantly higher than that in the control group,and c Tn I,c Tn T,CK-MB were significant Lower than the control group,the difference in pressure was statistically significant(P<0.05).3.1 day after treatment,the total effective rate(91.49%)of the treatment group was higher than that of the control group(68.63%),the difference was significant(P<0.05).4.One month after treatment,the mortality of ST-segment elevation and non-STsegment elevation patients in the treatment group was significantly lower than that of the control group(P<0.05).There was no statistically significant difference in infarction rate and MACE rate(P>0.05);6 months after treatment,the mortality,recurrent myocardial infarction rate and MACE incidence in the treatment group were significantly lower in ST-segment elevation and non-ST-segment elevation patients In the control group(P<0.05).ConclusionIABP combined with PCI has an application advantage in the treatment of AMI combined with CS,which can stabilize hemodynamics,reduce myocardial damage,increase urine output,improve short-term efficacy,and optimize prognosis. |
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