高血压对急性心肌梗塞患者近期预后的影响

Effect of hypertension on the short-term prognosis in patients with acute myocardial infarction

观察了高血压对268例急性心肌梗塞近期预后的影响。结果表明单纯高血压病史患者,发生急性心肌梗塞时,肌酸激酶(CPK)峰值与无病史组无明显差异。发病时血压急性暂时升高,亦不增加CPK峰值。一旦并发心绞痛,CPK峰值则显著降低(180.7±121.5对294.7±133.8)。然而,高血压病史组心功能不全、心脏破裂和住院病死率明显增多。提示长时间高血压引起的症状和无症状性心肌缺血刺激促使的侧支血管形成,不同程度地消除了高血压所致左室肥厚引起的心肌灌注不良。

The influence of hypertension on the short-term prognoss in 268 cases of acute myocardial in-farction was studied. The results showed that levels of the mean peak value of creatine kinase were notdifferent among 64 cases with previous history of hypertension and 11 cases with acute arterial hyper-tension that were previously normotensive,and 112 cases without previous history of hypertension or/and angina. However,the levels of the mean peak value of creatine kinase in 62 cases with previoushistory of hypertension and angina and 30 cases with angina were significantly lower than those in thecases without previous history of hypertension or/and angina (181±122 or 150±120 vs 270±149IU). The incidences of congestive heart failure,cardiac rupture,and in-hospital mortality jn cases withprevious history of hypertension and of congestive heart failure and cardiogenic shock in cases with a-cute arterial hypertension that were previously normotensive were significantly higher than those incases without previous history of hypertension or/and angina. It is demonstrated that the collateral ves-sel formation caused by repeated ischemia and by chronic hypertension dispelled the underperfusion ofcardiac muscle cells caused by hypertension and left ventricular hypertrophy.