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目的：本文观察早期冠状动脉再通及其他辅助治疗对急性心肌梗死（ＡＭＩ）合并心源性休克患者转归的影响。方法：对ＡＭＩ伴心源性休克的１７例患者进行回顾性研究，除外１例合并心室间隔穿孔。其余１６例患者分为药物组５例，仅应用药物治疗；介入组１１例接受溶栓，行经皮冠状动脉腔内成形术、行支架术、主动脉内球囊反搏、呼吸机辅助呼吸等治疗。介入组患者经冠状动脉造影后根据心肌梗死溶栓试验（ＴＩＭＩ）分级进一步分为再通组与未再通组。对药物组和介入组，再通组和未再通组住院期间病死率进行了比较。结果：药物组患者住院期间全部死亡，病死率１００％。介入组患者４例死亡，病死率３６％，较药物组明显降低（Ｐ＜０．０１）。介入组患者经冠状动脉造影未再通组（ＴＩＭＩ０～Ⅰ级）４例，３例死亡，病死率７５％，再通组（ＴＩＭＩⅡ～Ⅲ级）７例，死亡１例，病死率１４％，与未再通组比较病死率显著降低（Ｐ＜０．０１）。结论：早期冠状动脉再通，同时应用主动脉内球囊反搏，辅助呼吸等治疗将有效地降低ＡＭＩ伴心源性休克患者的病死率
Objective: This study was to observe the effects of early coronary revascularization and other adjuvant therapy on the outcome of patients with acute myocardial infarction (AMI) complicated by cardiogenic shock. Methods: Seventeen patients with AMI with cardiogenic shock were retrospectively studied, except one with ventricular septal perforation. The remaining 16 patients were divided into five groups of drugs, only the application of drug treatment; intervention group of 11 patients underwent thrombolysis, percutaneous transluminal coronary angioplasty, stent, intra-aortic balloon pump, ventilator-assisted breathing treatment. Intervention group patients after coronary angiography according to myocardial infarction thrombolysis test (TIMI) grading is further divided into recanalization group and non-recanalization group. The mortality rates of drug group and intervention group, recanalization group and non-recovery group during hospitalization were compared. Results: The patients in the drug group all died while hospitalized, the case fatality rate was 100%. In the intervention group, 4 patients died and the case fatality rate was 36%, which was significantly lower than that in the drug group (P <0.01). In intervention group, there were 4 cases without TIMP group (TIMI grade 0 ~ Ⅰ), 3 died and the case fatality rate was 75%. Seven cases were recanalized (TIMI Ⅱ ~ Ⅲ grade), 1 died and the case fatality rate was 14% Compared with non-recanalization group mortality was significantly lower (P <0.01). Conclusion: The early recanalization of the coronary artery, while the application of aortic balloon pump, assisted breathing and other treatments will effectively reduce the mortality of AMI patients with cardiogenic shock