缺血预适应对合并糖尿病的急性心肌梗死患者左室舒张功能的影响

Effects of Ischemic Preconditioning on Left Ventricular Diastolic Function in Diabetic Patients with Acute Myocardial Infarction

为探讨缺血预适应对合并糖尿病的急性心肌梗死 (AMI)患者左室舒张功能的影响 ,将 2 2 2例首次AMI患者分为 4组 :A组 :非糖尿病缺血预适应组 (4 3例 ) ,B组 :非糖尿病无缺血预适应组 (5 2例 ) ,C组 :糖尿病缺血预适应组 (60例 ) ,D组 :糖尿病无缺血预适应组 (67例 ) ;比较缺血预适应对肌酸激酶 (CK)峰值浓度和左室舒张功能的影响。结果 :CK、CK MB峰值浓度A组均显著低于其他各组 (P均 <0 .0 1 ) ,二尖瓣口舒张早期血流峰值流速 /舒张晚期血流峰值流速比值 (E/A比值 )A组均显著高于其他各组 (P <0 .0 5或P <0 .0 1 ) ,E/A比值 <1的发生率A组显著低于其他各组 (P均 <0 .0 1 ) ,而其余各组间这些指标均无显著性差异 (P >0 .0 5 )。提示 :缺血预适应对无糖尿病的AMI患者能够限制梗死面积 ,保护左室舒张功能 ,而对合并糖尿病的AMI患者 。

To investigate the short-term effects of ischemic preconditioning pectoris on left ventricular diastolic function in diabetic patients with acute myocardial infarction, 222 patients with first acute myocardial infarction were studied. 95 without diabetes were divided into group A(with IP) and group B (without IP). Another 127 with diabetes were divided into group C(with IP ) and group D(without IP). The effects of IP on peak creatine kinase value and left ventricular diastolic function were analyzed separately. Results: The peak creatine kinase value and the peak creatine kinase MB fractions were significantly lower in group A than those in the other groups (P<0.01 for each comparion). At the same time, the ratio of the early peak velocity/the late peak velocity in diastole of mitral flow (E/A) and the incidence of E/A<1 were significantly lower in group A than those in the other groups (P<0.05 or P< 0.01), while there was no significant difference between those in the other groups (P>0.05). Conclusion: Ischemic preconditioning could limit infarct size, protect the left ventricular diastolic function in non-diabetic patients with acute myocardial infarction. However, such beneficial effects of ischemic preconditioning have not been observed in diabetic patients.