周宁.主动脉内球囊反搏降低暴发性心肌炎患者的住院死亡率[J].内科急危重症杂志,2022,28(6):460-463
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| DOI：10.11768/nkjwzzzz20220606 |
| 中文关键词: 主动脉内球囊反搏 暴发性心肌炎 机械循环支持 心源性休克 院内死亡率 |
| 英文关键词: |
| 基金项目:国家自然科学基金（No:82070316） |
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| 中文摘要: |
| 摘要 目的：评价主动脉内球囊反搏(IABP)治疗对暴发性心肌炎(FM)患者院内死亡率的影响。方法：选取100例FM患者，根据患者在入院后30 min内是否应用IABP分为2组，其中接受IABP治疗(IABP组)57例(57%)，而未接受IABP治疗(非IABP组) 43例(43%)，评估患者住院死亡率(整个住院周期内)、血流动力学变化、心功能和心肌损伤情况。结果：100例患者中，死亡29例(29%)。非IABP组住院死亡率显著高于IABP组患者(34.9% vs 24.6%,P＜0.01)。与非IABP组比较，IABP组患者死亡风险降低了29.5%。入院时，2组患者的平均血压(MBP)、平均心率(AHR)、左室射血分数(LVEF)比较，差异无统计学意义（P均>0.05）。但与非IABP组比较，IABP组植入治疗30 min后收缩压（SBP）、舒张压（DBP）显著升高，AHR明显降低，IABP组患者植入24 h后LVEF值明显升高，同时血管活性药物剂量显著减少。结论: IABP治疗可降低FM患者住院死亡风险，改善患者心功能和血流动力学不稳定状态。 |
| 英文摘要: |
| Abstract Objective: To evaluate the effect of intra-aortic balloon pump (IABP) on in-hospital mortality in patients with fulminating myocarditis (FM). Methods: A total of 100 patients with FM were selected and divided into 2 groups according to whether they were treated with IABP within 30min after admission. Of the 100 patients with FM, 57 (57%) received IABPs within 30min after admission (IABP group), whereas 43 (43%) did not (non-IABP group). Patients' in-hospital mortality, hemodynamic changes, cardiac function, and biomarkers of myocardial injury were evaluated. Results: Of the 100 patients, 29 (29%) died. The in-hosptial mortality in non-IABP group was significantly higher than in the IABP group (34.9% vs 24.6%, P<0.01). The use of IABP reduced the mortality risk of FM in patients by 29.5%. There were no significant differences in mean blood pressure (MBP), average heart rate (AHR) and left ventricular ejection fraction (LVEF) between the two groups on admission (all P> 0.05). However, compared to the non-IABP group, SBP, DBP and LVEF were increased and AHR was significantly decreased 30min after IABP implantation. Application of the IABP significantly decreased the dose of vasopressors and inotropic agents. Conclusion: IABP reduced the in-hospital mortality risk and improved the hemodynamic instability, cardiac dysfunction in patients with FM. |
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