心肌缺血预适应对急性心肌梗死溶栓效果的影响  

Effect of Myocardial Ischemic Preconditioning on Thrombolytic Effect in Acute Myocardial Infarction

作　　者：覃松柏 QIN Songbai(Department of Cardiology, Jingzhou Hospital of Traditional Chinese Medicine, Jingzhou Hubei 434000, China)

机构地区：[1]湖北省荆州市中医医院心病科,湖北荆州434000

出　　处：《中国继续医学教育》2019年第10期112-114,共3页China Continuing Medical Education

摘　　要：目的探讨心肌缺血预适应患者临床指标的变化及预后情况,观察其对于急性心肌梗死患者的溶栓治疗效果影响。方法选取初发急性心肌梗死患者200例,其中以发生心肌缺血预适应的100例建立IP组,以未发生心肌缺血预适应的100例建立非IP组。对两组患者均予以尿激酶150万U+100 m L生理盐水静脉滴注治疗30 min,6 h后,每12 h予以1次低分子肝素5 000 U进行治疗,持续用药7 d。结果 IP组患者心肌酶峰值相比于非IP组患者显著更低,LVEF相比于非IP组显著更高,冠状动脉再通率以及再灌注再通的时间、预后情况相比于非IP组均显著更优,对比差异有统计学意义(P <0.05)。结论存在心肌缺血预适应状态的心肌梗死患者在尿激酶静脉溶栓治疗当中的疗效相比于无心肌缺血预适应状态患者效果更显著。Objective To investigate the changes and prognosis of clinical indicators in patients with myocardial ischemic preconditioning, and to observe its effect on thrombolytic therapy in patients with acute myocardial infarction. Methods 200 patients with initial acute myocardial infarction were enrolled, and 100 patients with myocardial ischemic preconditioning were established. The non-IP group was established in 100 patients without myocardial ischemic preconditioning. The patients in both groups were treated with urokinase 1.5 million U+100 m L saline intravenously for 30 minutes. After 6 hours, the low molecular weight heparin 5000 U was treated once every 12 hours for 7 days. Results The myocardial enzyme peak in the IP group was significantly lower than that in the non-IP group, and the LVEF was significantly higher than that in the non-IP group. The coronary recanalization rate and reperfusion time and prognosis were compared with those in the non-IP group. Significantly better, the comparison was statistically significant(P < 0.05). Conclusion The effect of myocardial infarction in patients with myocardial infarction in the treatment of urokinase intravenous thrombolysis is more significant than in patients without myocardial ischemic preconditioning.

关 键 词：心肌缺血预适应 急性心肌梗死 静脉溶栓治疗 治疗效果 近期预后 对比分析 

分 类 号：R542[医药卫生—心血管疾病]