心肌缺血预适应对初次急性心肌梗死左室功能的影响

MYOCARDIAL ISCHEMIC PRECONDITIONING IN LEFT VENTRICULAR FUNCTION OF PRIMARY ACUTE MYOCARDIAL INFARCTION

目的 观察心肌缺血预适应对急性心肌梗死左室功能的影响。方法 5 2例无并发糖尿病的急性心肌梗死患者按发病前 4 8h有无心绞痛分为有心肌缺血预适应 (A)组和无心肌缺血预适应 (B)组。应用超声心动图及彩色多普勒技术检测各组左室射血分数 (LVEF)、每搏输出量 (SV)、心输出量 (CO)及二尖瓣口E峰、A峰、E/A、E峰流速积分 (VTIE)、A峰流速积分 (VTIA)、VTIE/VTIA,并与对照 (C)组进行比较。结果 ①A、B二组的LVEF、SV下降 ,与C组比较差异有统计学意义 ,其中B组较A组下降更明显 ,二组间比较差异有统计学意义 ;CO下降不明显。②A、B二组E峰及VTIE 下降 ,E/A、VTIE/VTIA 减低 ,与C组比较差异有统计学意义 ,其中B组与A组比较有统计学意义 ;A峰及VTIA 增大 ,B组升高更明显 ,与C组比较有统计学意义。结论 急性心肌梗死后左室收缩及舒张功能均减低 ,有心肌缺血预适应组较无心肌缺血预适应组减低程度较小 。

Objective To investigate the effects of ischemic preconditioning(IP) on left ventricular function of the acute myocardial infarction. Methods 52 patients who suffered from acute myocardial infarction but without diabetes at the primary time were divided into two groups:IP(A)group,non-IP(B)group. Echocardiography and color doppler flow image were implied to measure LVEF,CO,SV,E and A peak flow velocity during diastole,VTI E,VTI A,E/A,VTI E/VTI A, and the parameters were compared with the control group. Results ①EF and SV decreased in group A and B,especially in the group B,parameters in both groups had significant difference compared with the controls,parameters in group B had significant difference compared with that in group A.CO showed no statistical difference among group A,B and C.②E peak,VTI E,E/A,VTI E/VTI A decreased in group A and B,both had significant difference compared with the controls.The parameters in group B had significant difference compared with those in group A.A peak and VTI A increased in group A and B,both had significant difference compared with the controls. Conclusion Acute myocardial infarction can result in dysfunction of left ventricular systolic and diastolic function,the decrease was more notable in non-IP group than that in IP group.IP seems to be able to protect the left ventricular function.