急性心肌梗死并发心源性休克的干预进展

Progress on intervention for acute myocardial infarction complicated with cardiogenic shock

摘要:

心源性休克是急性心肌梗死（AMI）最严重的并发症之一，其发病率为7%～10%。近些年，随着经皮冠状动脉介入术（PCI）、冠状动脉旁路移植术（CABG）等血运重建技术的熟练应用和多巴胺、主动脉球囊反搏技术（IABP）的有效配合，以及新型药物左西孟坦和心室辅助装置（VAD）、体外膜氧合（ECMO）的应用，其病死率由70年代的70%～80%下降到50%。本文综述了急性心肌梗死并发的心源性休克的诊断标准、病理生理机制、尤其是干预手段的应用进展。

Abstract:

Cardiogenic shock is one of the most serious complications of acute myocardial infarction with an incidence rate of 7% to 10%. In recent years, with the development of revascularization techniques, such as percutanous coronary intervention (PCI) and coronary artery bypass grafting (CABG), the effective cooperation of dopamine and intraaortic balloon pumping (IABP), and the application of new drug-levosimendan, and mechanical circulatory assist devices, ventricular assist device (VAD) and extracorporeal membrane oxygenation (ECMO), the mortality rate has declined from 70%-80% in 1970s to 50% now. In this paper, we summarized the diagnostic criteria, pathophysiology and interventional measures for cardiogenic shock secondary to acute myocardial infarction.