缺血预适应对急性心肌梗死临床及预后的影响

目的探讨心肌缺血预适应(IP)对急性心肌梗死临床及预后的影响。方法对209例急性心肌梗死(AMI)患者的临床资料进行回顾性分析。根据梗死前有无心绞痛分为IP组和无IP的对照组。结果IP组小面积心肌梗死发生率高于对照组,而肌酸磷酸激酶(CK)和肌酸磷酸激酶同工酶(CK-MB)峰值、KollipⅡ级以上泵衰竭和梗死后心绞痛发生率、住院病死率均明显低于对照组,但两组恶性心律失常发生率无明显差异。结论梗死前心绞痛对AMI具有保护作用,主要表现为限制梗死面积的扩大,维护梗死后心功能,降低泵衰竭发生率和住院病死率。

Effect of ischemia pre-adaptation on clinic and prognosis of patients with acute myocardial infarction

Objective To evaluate the effect of ischemia pre-adaptation on clinic and prognosis of patients with acute myocardial infarction(AMI).Methods Two hundreds and nine cases with AMI were analysized retrospectively.They were separated into IP and P groups according to whether having angina pectoris before acute myocardial infarction.Results Compared with the control group,the IP group had a high rate of small-size myocardial infarction and had a significant decline in the peak of CK and CK-MB.Furthermore,much fewer events of pump failure(kollip Ⅱ～Ⅳ) and postmyocardial infarction angina as well as of death in hospital were demonstrated in IP group,however,the rates of life-threatening arrhythmia are similar in 2 groups.Conclusion Ischemia pre-adaptation can provide an important cardiac function-protective effect in AMI.It will limit the infarct size,sustain the cardiac function after myocardial infarction and decrease the events of bump failure and death in hospital.