远程缺血预适应对急性ST段抬高型心肌梗死患者血清内皮细胞特异性分子-1的影响  

Effect of remote ischemic preconditioning on serum endothelial cell specific molecule-1 in patients with acute ST-segment elevation myocardial infarction

作　　者：付幼林 张鹏 钟日祥 谢自强 高鑫 FU Youlin;ZHANG Peng;ZHONG Rixiang;XIE Ziqiang;GAO Xin(Department of Cardiovascular Medicine,Ganzhou People's Hospital,Ganzhou,Jiangxi,341000,China;Department of Cardiovascular Medicine,Longnan City First People's Hospital,Ganzhou,Jiangxi,341700,China)

机构地区：[1]赣州市人民医院心血管内科,江西赣州341000 [2]龙南市第一人民医院心血管内科,江西赣州341700

出　　处：《当代医学》2022年第34期28-31,共4页Contemporary Medicine

基　　金：赣州市指导性科技计划(GZ2018ZSF274)。

摘　　要：目的分析远程缺血预适应对急性ST段抬高型心肌梗死(STEMI)患者血清内皮细胞特异性分子-1(ESM-1)的影响。方法选取2018年5月至2020年7月本院收治的100例急性STEMI患者作为研究对象,按照随机数字表法分为对照组与研究组,每组50例。对照组给予常规对症治疗,研究组在对照组基础上给予远程缺血预适应治疗。比较两组ESM-1水平、心肌酶[肌酸激酶(CK)、肌酸肌酶同工酶(CK-MB)、肌钙蛋白(Tn)]、心功能指标[左室射血分数(LVEF)、左心室缩短分数(FS)、左心室舒张末期内径(LVEDD)、左心室收缩末期直径(LVESD)]及不良心血管事件发生率。结果治疗5 d,研究组ESM-1水平低于治疗前,且研究组低于对照组,差异有统计学意义(P<0.05)。研究组CK、CK-MB、Tn水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗5 d,两组LVEF、FS均高于治疗前,LVEDD、LVESD均短于治疗前,且研究组的LVEF、FS均高于对照组,LVESD短于对照组,差异有统计学意义(P<0.05),两组LVEDD比较差异无统计学意义。研究组不良心血管事件发生率为6.00%,低于对照组的20.00%,差异有统计学意义(P<0.05)。结论远程缺血预适应治疗急性STEMI患者可有效降低心肌酶指标、ESM-1水平,改善心功能,降低不良心血管事件发生率,安全性高,值得临床推广应用。Objective To analyze the effect of remote ischemic preconditioning on serum endothelial cell specific molecule-1(ESM-1)in patients with acute ST segment elevation myocardial infarction(STEMI).Methods 100 patients with acute STEMI admitted to our hospital from May 2018 to July 2020 were selected as the research subjects,and they were divided into control group and study group according random number table method,with 50 cases in each group.The control group received conventional symptomatic treatment,and the study group received remote ischemic preconditioning based on the control group,the ESM-1 levels,myocardial enzymes(creatine kinase[CK],creatine kinase-MB[CK-MB],troponin[Tn]),cardiac function indexes(left ventricular ejection fraction[LVEF],left ventricular shortening fraction[FS],left ventricular end diastolic dimension[LVEDD],left ventricular end systolic diameter[LVESD])and the incidence of adverse cardiovascular events were compared between the two groups.Results After 5 d of treatment,the level of ESM-1 in the study group was lower than before treatment,and that in the study group was lower than that in the control group,the difference was statistically significant(P<0.05).The levels of CK,CK-MB and Tn in the study group were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).After 5 d of treatment,LVEF and FS of the two groups were higher than before treatment,LVEDD and LVESD were shorter than before treatment,and LVEF and FS of the study group were higher than the control group,LVESD was shorter than the control group,the difference was statistically significant(P<0.05),there was no statistically significant difference in LVEDD between the two groups.The incidence of adverse cardiovascular events in the study group was 6.00%,which was lower than 20.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion Remote ischemic preconditioning in the treatment of patients with acute STEMI can effectively reduce myocard

关 键 词：急性ST段抬高型 心肌梗死 远程缺血预适应 血清内皮细胞特异性分子-1 

分 类 号：R542.22[医药卫生—心血管疾病]