梗死前心绞痛对合并糖尿病的急性心肌梗死患者左心室功能的影响  

Effects of prodromal angina pectoris for left ventricular function in diabetic patients with acute myocardial infarction

作　　者：马彩云[1] 杜凤和[1] 于东明[1] 张立克[2] 杨红莲[1] 田俊萍[1] 

机构地区：[1]首都医科大学附属北京天坛医院心内科,北京100050 [2]首都医科大学病理生理教研室

出　　处：《临床内科杂志》2003年第7期356-358,共3页Journal of Clinical Internal Medicine

摘　　要：目的　探讨梗死前心绞痛对合并糖尿病的急性心肌梗死 (AMI)患者左心室功能的近期影响。方法　 2 2 2例行选择性冠状动脉造影和多普勒超声心动图的首次AMI患者 ,其中有 12 7例合并有糖尿病 ,分组比较梗死前心绞痛对肌酸激酶 (CK)峰值浓度和左心室功能的影响。共分为以下 4组进行观察。非糖尿病有梗死前心绞痛组 (A组 ) 43例 ,非糖尿病无梗死前心绞痛组 (B组 )5 2例 ,糖尿病有梗死前心绞痛组 (C组 ) 60例 ,糖尿病无梗死前心绞痛组 67例。结果　CK、CK MB的峰值浓度A组显著低于B组 (P <0 .0 1) ,左心室射血分数 (LVEF)值A组显著高于B组 (P <0 .0 5 )。C组与D组各项指标比较差异均无显著性 (P均 >0 .0 5 )。结论　梗死前心绞痛在无糖尿病的AMI患者中能够限制梗死面积 ,保护左心室功能 ,而在合并糖尿病的AMI患者中 ,对心脏的保护作用不明显 。Objective To investigate the short term effects of prodromal angina pectoris on left ventricular function in diabetic patients with acute myocardial infarction.Methods 222 patients with first acute myocardial infarction:95 without diabetes,divided into group A(with prodromal AP)and group B(without AP).Another 127 with diabetes were divided into group C(with prodromal AP)and group D(without prodromal AP ).The effects of IP on peak creatine kinase value and left ventricular function were analyzed separately.Results (1)The peak creatine kinase value and the peak creatine kinase MB fractions were significantly lower in group A than group B( P <0.01),at the same time,the left ventricular ejection fraction(LVEF)was significantly higher in group A than group B( P <0.05),while there were no significant difference between group C and group D( P >0.05 for both comparisons).Conclusion prodromal angina pectoris limited infarct size,protect the left ventricular function in non-diabetic patients with acute myocardial infarction.However,such beneficial effects of prodromal angina pectoris were not observed in diabetic patients, suggesting that diabetes might prevent ischemic preconditioning. \[

关 键 词：急性心肌梗死 合并症 糖尿病 心绞痛 左心室功能 

分 类 号：R541.4[医药卫生—心血管疾病]