缺血预处理对急性心肌梗死溶栓治疗冠脉再通及预后的影响

Ischemic Preconditioning of Thrombolytic Therapy in Patients with Acute Myocardial Infarction Coronary Artery Recanalization and Clinical Analysis of the Impact on the Prognosis

目的缺血预适应对急性心肌梗死(AMI)溶栓治疗后冠脉血管再通率及近期预后的影响。方法对86例AMI并进行尿激酶溶栓患者的临床资料进行分析,按梗死前有无心绞痛分为心绞痛组(IP)与非心绞痛组(对照组),比较两组患者对心肌酶浓度、冠脉再通率、左室功能及心脏事件发生率的影响。结果(1)IP组尿激酶溶栓血管再通率及再通速率高于对照组(P<0.05);(2)IP组AMI后血清心肌酶峰值、梗死面积及心脏主要并发症及住院病死率明显降低对照组(P<0.05);(3)IP组AMI后EF恢复优于对照组(P<0.05)。结论梗死前心绞痛对缺血心肌起明显的保护作用;对提高AMI溶栓后血管再通率、从而减少梗死面积和心肌的损害程度,降低病死率。

Objective Purpose of ischemic preconditioning on acute myocardial infarction （AMI） after thromboiytic therapy in coronary vascular recanalization rate and short - term prognosis. Methods 86 cases of AMI patients with urokinase and the clinical data analysis, according to pre - infarction angina divided into groups of angina pectoris （IP） and non - angina group （the control group） , compared between the two groups of patients with myocardial enzyme concentration, coronary recanalization rate, left ventrieular function and the incidence of cardiac events affected. Results （ 1 ） IP group urokinase vascular reeanalization rate of recanalization rate and the control group （ P 〈 0.05） （2） IP group AMI peak serum myocardial enzymes, cardiac infarction area and major complications and hospitalization, illness the control group was significantly lower （ P 〈 0.05 ） （3） IP EF resume after AMI group than the control group （ P 〈 0. 05 ）. Conclusion Infarction angina pectoris on myocardial isehemia from the obvious protective effect on the increase after thrombolysis AMI vascular recanalization rate, and thereby reduce myocardial infarct size and the degree of damage, and reduce the mortality.