心肌缺血预适应与急诊经皮穿刺冠状动脉腔内成形术时机选择

目的明确心肌缺血预适应与急诊经皮穿刺冠状动脉腔内成形术(PCI)手术时机之间的关联.方法观察我院1996年1月～2003年12月的289例急性心肌梗死患者.分别统计有心绞痛病史组与无心绞痛病史组在常规药物治疗、发作12h内及12～24h行急诊PCI后住院期间的心律失常、心功能衰竭、心源性休克、临床死亡率等情况.结果缺血预适应组在心律失常、心功能衰竭、心源性休克、临床死亡率等方面优于对照组,在同组内心功能衰竭、心源性休克、临床死亡率等方面在12～24h行急诊PCI与常规药物治疗对照上,缺血预适应组存在明显差异,对照组无差异;发作12h内与12～24h行急诊PCI对照上缺血预适应组心功能衰竭上存在明显差异,对照组心功能衰竭、心源性休克对照上存在明显差异.结论心肌缺血预适应效应对心肌的保护作用明显延长了急诊PCI的手术适应时间.

The myocardia ischemia precondition and the time of acute percutaneous transluminal coronary angioplasty(PTCA)

Objective To investigate the relationship of the myocardia ischemia precondition and the time of acute percutaneous transluminal coronary angioplasty.Methods We analized 289 patients with acute myocardia infarction in our hospital from January 1996 to November 2003. The occurrence of arrhythmic,heart failure, cardiac shock and death in the patients with and without angina were recorded in conventional drug treatment group, in 12h and 12h-24h after chest pain in PCI group.Results The occurrence of arrhythmic, heart failure, cardiac shock and death in ischemia precondition group were significantly lower than that in control group. The occurrence of heart failure, cardiac shock and death were different between the patients treated with acute PCI and the patients treated with conventional drugs in ischemia precondition group, but showed no significant difference in control group. The occurrence of heart failure was different between the patients treated with PCI in 12h and that in 12h-24h in ischemia precondition group, and the occurrence of heart failure and cardiac shock was different between the patients treated with PCI in 12h and that in 12h-24h in control group.Conclusion Ischemia precondition protected myocardium and significantly increased the duration of acute PCI.