• 惠州市惠陽(yáng)第一人民醫(yī)院CCU病區(qū)( 廣東惠州 516211)通訊作者: 方快發(fā), E-mail: kuaifa2004@ yahoo. com. cn;

目的  探討急性心肌梗死并發(fā)肺水腫患者在機(jī)械通氣支持下, 進(jìn)行緊急冠狀動(dòng)脈介入治療( PCI) 的可行性。方法  回顧性分析2007 至2009 年在急診室確診急性心肌梗死并發(fā)肺水腫, 在機(jī)械通氣支持下行緊急P(pán)CI 的15 例患者的病歷資料, 分析其臨床資料、左室射血分?jǐn)?shù)、血漿腦鈉肽( BNP) 及高敏C 反應(yīng)蛋白( hs-CRP) 水平。結(jié)果  15 例患者全部手術(shù)成功, 病情恢復(fù)良好并逐步脫機(jī), 左室射血分?jǐn)?shù)( LVEF) 顯著改善[ 機(jī)械通氣支持介入結(jié)束后EF為( 37. 36 ±0. 02) % , 脫機(jī)前EF為( 47. 41 ±0. 02) % , P  lt;0. 05) ; 血漿腦鈉肽水平[ 介入治療前為( 430. 50 ±96. 08) fmol /mL, 介入治療后4 周為( 99. 34 ±5. 15) fmol /mL] 和血清hs-CRP濃度[ 介入治療前為( 89. 50 ±9. 30) ng/mL, 介入治療后4 周為( 8. 35 ±2. 49) ng/mL] 隨治療時(shí)間逐漸降低( P 均 lt; 0. 01) 。結(jié)論  急性心肌梗死肺水腫患者在呼吸機(jī)支持下行緊急P(pán)CI 治療具有可行性和較好的療效。

引用本文: 方快發(fā),劉文兵,饒志榮,王寧生,楊友祥. 機(jī)械通氣支持下行緊急介入治療急性心肌梗死并發(fā)肺水腫. 中國(guó)呼吸與危重監(jiān)護(hù)雜志, 2010, 9(3): 281-283. doi: 復(fù)制

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  3. 3. Stanek B, Frey B, Hülsmann M, et al. Prognostic evaluation of neurohumoral plasma levels before and during beta-blocker therapv inadvanced left ventricular dvsfunction. J Am Coll Cardiol, 2001 , 38 :436-442.
  4. 4. Ridker PM, Hennekens CH, Roitman-Johnson B, et al. Plasma concentration of soluble intercellular adhesion molecule 1 and risks of future myocardial infarction in apparently healthy men. Lancet, 1998 ,351: 88 -92.
  5. 5. Asada J, Tsuji H, Iwasaka T, et al. Usefulness of plasm a brain natriuretic peptide levels in predicting dobutam ine-induced myocardial ischemia. Am J Cardiol, 2004, 93: 702 -704.
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