缺血预适应对急性心肌梗死预后的影响

Impact of Ischemic Preconditioning on Prognosis in Patients with Acute Myocardial Infarction

目的通过对急性心梗患者临床指标的观察,评价缺血预适应对急性心肌梗死患者预后的影响。方法296例急性心梗患者依发病前24小时内有无心绞痛分为缺血预适应组(IP组)和无缺血预适应组(NIP组)。观察两组间ST段抬高程度、心肌酶峰值、心电图积分、左室射血分数(EF)、室壁瘤、右束支阻滞、休克、心衰的差异。结果IP组ST段抬高的程度(P<0.05)、心肌酶峰值(P<0.05)、心电图积分(P=001)、室壁瘤(P<0.05)、右束支阻滞(P<0.05)、休克(P<0.05)、心衰(P=0.01)的发生机会均低于NIP组。EF(P=0.02)则高于NIP组。结论IP现象可明显改善急性心梗患者的预后。

Objectives to evaluate the impact of the Ischemia Preconditioning on prognosis in patients with acute myocardial infarction. Methods 296 patients were divided into ischemic preconditioning group（IP） and non-ischemic precondtioning group（NIP） according to the absence or presence of preinfarction angina within 24hours. There were 110 patients in IP. It were detected that the differences of degree of ST elevation, peak value of cardiac enzymes, the score of ECG, left ventricular ejection fraction（LVEF） ,right bundle branch block（RBBB） ,shock and heart failure. Results compared with ones in INP, the degree of elevated ST segment, as well as peak value of cardiac enzymes, the score of ECG, was lower in IP. The rates of RBBB,sheck and heart failure were also lower in IP than that in NIP. But the LVEF was higher in IP than that in NIP. Conclusion ischemic preconditioning can improve the prognosis in patients with acute myocardial infarction.