摘要
近年来冠心病发病率逐年增高，在人类死亡原因中占首位。除传统保守治疗和外科搭桥外，经皮冠脉介入（PercutaneousCoronaryIntervention，PCI）因不开胸，可重复进行，不需全麻，创伤性小等优势而被迅速推广和普及，成为治疗冠心病的主要方法。PCI是ST段抬高型心肌梗死（ST-segmentElevationMyocardiolInfarction，STEMI）急诊冠脉早期再通的最有效方法，可立即、
Objective:To observe the protective effect of ischemia postconditioning during the first minutes of reperfusion for the myocardial reperfusion injury in ST segment elevation acute myocardial infarction(STEMI)patients undergoing emergency percutaneous coronary intervention(PCI). Method:STEMI patients undergoing emergency PCI in hospital between Jan.2005and Jan.2012,were randomly divided into the control group(n =40)without any intervention after PCI and the postconditioning(Post C)group(n=50)with ischemia postconditioning within first 5minutes of fellow by 3episodes of 30seconds inflation and 30seconds deflation with the angioplasty balloon.Reperfusion arrhythmias,cTnT and CK-MB, corrected TIMI frame count(CTFC),wall motion score index(WMSI) and left ventricular ejection fraction(LVEF)by echocardiography were compared between the two groups.MI areas were evaluated with the ECT and myocardial blush grade(MBG)was measured.Results:(1)The incidence of reperfusion arrhythmias in PostC group was less than control group(P<0.05);(2)Short array ventricular peaks of cTnT[(0.27±0.18)ng/L vs(0.38±0.21)ng/L,P<0.01],CK-MB(41.22±11.41)U/L vs(49.61±19.32)U/L,P<0.01]were significantly lower in the PostC group than control group.(3)CTFC[(34.21±8.37)vs(29.32±7.35), P<0.05]was significantly higher in the PostC group than in control group.MIS[(17.42±3.26)% vs(25.52±2.49)%,P<0.05]was significantly higher in control group than in PostC group.(4)While LVEF [(49.33±4.57)% vs(43.46±5.32)%,P<0.05]and MBG(2.54±1.23vs 1.41±1.31,P<0.05)in Post C group were higher than control group.But WMSI(1.74±0.89vs 2.13±0.46,P<0.05)was significantly lower in the PostC group than control group.Conclusion:Ischemic postconditioning can significantly reduce myocardial reperfusion injury in patients with STEMI.
出处
《微循环学杂志》
2013年第4期37-39,44,I0002,共5页
Chinese Journal of Microcirculation
基金
内蒙古自治区自然科学基金(2012MS1179)
