糖尿病对急性心肌梗死缺血预适应的影响  

The Effect of Diabetes on Ischemic Preconditioning in Patients with Acute Myocardial Infarction

作　　者：刘柏年[1] 孙根义[1] 

机构地区：[1]天津市胸科医院心内二科,300051

出　　处：《天津医药》2003年第8期500-502,共3页Tianjin Medical Journal

摘　　要：目的 :研究急性心肌梗死 (AMI)合并糖尿病 (DM )的缺血预适应 (IP)效应。方法:选择AMI合并2型DM患者 (DM组 )117例 ,同期无糖尿病AMI患者 (非DM组 )412例。按AMI前24h有无梗死前心绞痛发作分为AP( +)组及AP( -)组 ,分别分析其冠心病危险因素、AMI并发症及心源性住院病死率等指标。结果 :非DM组中AP( +)组的CK -MB峰值、室速及心力衰竭发生率以及心源性住院病死率均明显低于AP(- )组 ,出院时LVEF明显高于AP(- )组 (P<0.05) ;DM组中AP( +)组及AP(- )组上述各项指标均无显著性差异。结论 :梗死前心绞痛对于无糖尿病的AMI病人具有心脏保护作用 。Objective:To study ischemic preconditioning in diabetic patients with acute myocardial infarction(AMI).Methods:One hundred and seventeen patients with type2diabetes and AMI(DM group)were divided into two groups which included AP(+)and AP(-)according to the presence and absence of pre-infarction angina episodes occurring within24h before the onset of AMI.Four hundred and twelve patients with non-diabetes and AMI(non-DM group)were also studied.The risk factors of coronary heart disease,the complication of AMI,and in-hospital cardiogenic mortality were analyzed.Results:In non-DM group,the peak of CK-MB value,incidence of ventricular tachycardia,heart failure,and cardiogenic mortality were lower in AP(+)subgroup compared with that in AP(-)subgroup,and pre-discharge LVEF was higher in AP(+)subgroup compared with that in AP(-)subgroup.Conclusion:Pre-infarction angina has a cardiac protective effect in non-diabetic patients with AMI,and the ischemic pre-conditioning effect is lost in diabetic patients with AMI.

关 键 词：糖尿病 急性心肌梗死 缺血预适应 危险因素 并发症 发生机理 防治 

分 类 号：R587.1[医药卫生—内分泌] R542.22[医药卫生—内科学]