心肌缺血后适应对老人急性心肌梗死临床及预后的影响

目的 探讨心肌缺血后适应对老人急性心肌梗死临床及预后的影响.方法 选择首次发生急性心肌梗死老年患者65例,分为缺血后适应组(适应组)及对照组,均接受急诊经皮冠状动脉介入术(pereutaneous coronary intervention,PCI).对照组行常规PCI.测定两组术前及术后肌酸激酶及心肌型肌酸激酶同工酶水平;测量术后左心室舒张末期容积指数、左心室收缩末期容积指数、左心室射血分数;观察术后严重心律失常、心力衰竭、心源性休克发生率及住院期间病死率.结果 与对照组比较,适应组术后肌酸激酶及心肌型肌酸激酶同工酶峰值水平明显减低;术后3个月左心室容积减小,左心室舒张末期容积指数升高(65.2±6.7)ml/m2与(70.4±6.3)ml/m2,P＜0.05],左心室收缩末期容积指数升高(31.4±3.2)ml/m2与(35.6±3.5)ml/m2,P＜0.05],左心室射血分数升高(0.52±0.03与0.49±0.02,P＜0.05);但严重心律失常、心力衰竭、心源性休克发生率减低、住院期间病死率的差异无统计学意义.结论 心肌缺血后适应可以改善老年人急性心肌梗死的体征,对梗死后心肌具有一定的保护作用.

Effect of ischemic postcondition on clinical course and prognosis in elderly patients with acute myocardial infarction

Objectives To evaluate the effect of ischemic postcondition on clinical course and prognosis in elderly patients with acute myocardial infarction(AMI).Methods A total of sixty-five patients with AMI were enrolled the study: 32 AMI patients in ischemic postconditioning(PC)group and 33 patients in non-ischemic postconditioning(NPC) groups.The levels of plasma CK,CK-MB were evaluated.The parameters of left ventricular end diastolic volume index,left ventricular end systolic volume index,and left ventricular ej...