心肌缺血预适应对初次急性心肌梗死患者临床及近期预后的影响  

Effects of myocardial ischemic preconditioning on first acute myocardial infarction and short-term prognosis

作　　者：李明琰[1] 滕清雷[2] 高红艳 

机构地区：[1]洛阳市中心医院干部内科,河南洛阳471000 [2]新乡医学院三附院,河南新乡453003 [3]新疆维吾尔自治区急救中心,新疆维吾尔830004

出　　处：《新乡医学院学报》2006年第1期66-68,共3页Journal of Xinxiang Medical University

摘　　要：目的评价急性心肌梗死(AMI)发病前48h内的心绞痛发作对初次AMI临床及近期预后的影响。方法138例均为初次AMI患者,按发病前48h内有无心绞痛发作,分为缺血预适应(IP)组(n=54)和非缺血预适应(NIP)组(n=84),对比两组心肌酶峰值、恶性心律失常、心源性休克及院内死亡率。结果IP组临床及近期预后较好,表现为心肌梗死范围较小(P<0.05),心肌酶峰值较低(P<0.05),近期住院期间严重心律失常、心源性休克、明显心力衰竭、心源性病死率均低于NIP组(P<0.05)。结论初次AMI前48h内心绞痛的发作对心肌有一定的保护作用,其机理可能与心肌缺血预适应有关。Objective To evaluate effects of angina pectoris attack on first acute myocardial infarction （AMI）. and short-term prognosis within 48 h before AMI. Methods According to whether angina pectoris occurred or not within 48 h before AMI, 138 patients were divided into ischemic preconditioning（IP） group（54 cases） and non-ischemic preconditioning （NIP） group （84 cases）. Peak value of myocardial enzyme, malignant arrhythmia, cardiogenic shock and death rate in hospital were compared in two groups. Results The clinical features and short-term prognosis of group IP were better than that of group NIP, which was by demonstratied following facts：size of myocardial infarction was smaller （P 〈 0.05）, the peak value of myocardial enzyme was lower（P 〈 0.05）, incidence of malignant arrhythmia, cardiogenic shock , dominant heart failure, cardiogenic mortality were lower in group IP than those in group NIP（P 〈 0.05）. Conclusion Angina pectoris attack within 48 h before first AMI passesses some to protective effect for myocardium. Its mechanism may be related to myocardial IP.

关 键 词：缺血预适应 急性心肌梗死 心绞痛 

分 类 号：R542.22[医药卫生—心血管疾病]