梗死前心绞痛对急性心肌梗死临床及预后的影响

目的:探讨梗死前心绞痛对急性心肌梗死(AMI)临床及预后的影响.方法:对149例AMI患者的临床资料进行分析,根据梗死前有无心绞痛分为心绞痛和无心绞痛两组,观察其心肌梗死范围、心肌酶峰值、严重心律失常、KillipⅡ级以上泵衰竭、左室射血分数(LVEF)、梗死后心绞痛和病死率.结果:心绞痛组小面积心肌梗死发生率和LVEF高于无心绞痛组,而肌酸磷酸激酶(CK)及其同工酶(CK-MB)峰值、KillipⅡ级以上泵衰竭、梗死后心绞痛、严重心律失常均明显低于无心绞痛组,两组差异有显著性.结论:梗死前心绞痛对AMI的缺血心肌具有保护作用,其机制可能与缺血预适应有关.

Influence of Pre- infarction angina on Ventricular Clinical and Prognosis of Acute Myocardial Infarction

Objective: To investigate the effect of pre - infarction angina pectoris on clinic and prognosis of patients with acute my ocardial infarction (AMI). Methods: 149 subjects were divided into angina pectoris group and non - angina pectoris group by pre - infarc tion angina pectoris. To observe the size of infarction,the peak serum cardiac makers, severe arrhythmias, heart failure, left ventricle ejection fraction(LVEF), post - infarction angina pectoris and mortality rate. Results:The size of infarction,LVEF in angina pectoris group were significantly higher than those in non - angina pectoris group; but the peak of creatine kinase(CK) and creatine kinase -MB, heart failure, post - infarction angina pectoris, severe arrhythmias, in angina pectoris group were significantly lower than those in non - angina pectoris group. Conclution: Pre-infarction angina pectoris can protect ischemic myocardium in patients with AMI, the mechanism was likely involved with ischemic preconditioning.