心肌缺血预适应对急性心肌梗死后临床及预后的影响

Effects of ischemic preconditioning on clinical manifestation and prognosis in patients with acute myocardial infarction

目的 探讨心肌缺血预适应 (IP)对急性心肌梗死 (AMI)临床及预后的近期影响。方法 根据心肌梗死前有无心肌缺血证据或 (和 )心绞痛病史将 198例患者分为A、B两组。对其临床资料进行回顾分析。结果 A组小面积心肌梗死发生率高于B组 ,而肌酸磷酸激酶 (CK)和同工酶 (CK MB)峰值、严重心脏并发症和梗死后心绞痛发生率、近期住院病死率均明显低于B组。结论 既往心绞痛促进冠状动脉侧支循环的建立 ,发病前心绞痛可能促进IP产生 ,二者协同对AMI后的心肌细胞起保护作用。

Objective To investigate the short-term effects of ischemic preconditioning(IP) on clinical and prognosis in patients with acute myocardial infarction(AMI).Methods Clinical data of 198 cases in A and B group divided according to the evidence of myocardial ischemia or history of angina pectoris were retrospectively analyzed.Results The incidence rate of small size infarction was higher in group A than in group B while the peak of creatine phosphokinase and creatine kinase isoenzym,the incidence rate of severe cardiac complications and angina pectoris following infarction and short-term in hospital death rate were lower in group A than in group B.Conclusion Previous angina pectoris promotes the collateral circulation of coronary artery,which may induce IP before onset,while IP and the establishment of collateral circulation coordinate to exert the protective role in myocardial cells.