心肌缺血预适应对 STEMI 患者心功能心肌损伤指标及并发症的影响

目的：探讨心肌缺血预适应对 ST 段抬高型心肌梗死（STEMI）患者心功能、心肌损伤指标及并发症的影响，为 STEMI 患者的治疗提供理论依据。方法：选取本院2010年1月至2014年12月收治的 STEMI 行溶栓治疗的患者96例进行分析，根据心肌梗死发病前48h 内有无心绞痛发作将96例患者分为心肌缺血预适应组49例和无缺血预适应组47例，采用心脏超声观察比较两组患者心功能，采用Elisa 法检测心肌酶和心肌损伤情况，以及对两组患者溶栓后随访4周，观察其并发症发生情况，并进行统计学分析。结果：入组前，缺血性预适应组患者左室射血分数（LVEF）高于无缺血预适应组，差异具有统计学意义（P＜0．05）；缺血性预适应组患者左室舒张末内径和左室收缩末内径均短于无缺血预适应组，差异具有统计学意义（P＜0．05）；治疗后，缺血性预适应组心肌肌钙蛋白（cTnI）和肌酸磷酸激酶同工酶（CK－MB）低于无缺血预适应组，差异具有统计学意义（P＜0．05）。结论：心肌缺血预适应对心肌具有保护作用，对保护心功能、减轻心肌损伤以及降低治疗后的并发症发生有着显著作用。

Effects of Myocardial Ischemic Preconditioning on Cardiac Function Myocardial Injury Index and Complications in Patients with STEMI

Objective: To discuss the effects of myocardial ischemic preconditioning on cardiac func -tion, myocardial injury index and complications in patients with STEMI so as to offer theoretical basis for the treatment of patients with STEMI.Methods: 96 cases of patients with STEMI treated by thrombolytic treatment in our hospital from January 2010 to December 2014 were selected.According to whether presenting with angi -na or not before myocardial infarction attack within 48h, 96 cases of patients were divided into myocardial is -chemic preconditioning group (49 cases) and 47 cases of patients with no myocardial ischemic preconditioning group, heart function of patients in two groups were observed and compared by echocardiography , myocardial enzymes and myocardial injury were detected by ELISA method , patients of two groups were follow -up for 4 weeks after thrombolysis, the occurrence of complications of patients were observed and statistically analyzed . Results:Before entering the group, ischemic preconditioning of patients with left ventricular ejection fraction (LVEF) was significantly higher than that of patients of non ischemic preconditioning group , P <0.05; Left ventricular end diastolic diameter and left ventricular end systolic diameter of patients of ischemic precondition -ing group were significantly shorter than those of non ischemic preconditioning group P <0.05; After treatment, cardiac troponin of patients of ischemic preconditioning group (cTnI) and creatine kinase isoenzyme (CK-MB) were significantly lower than those of non ischemic preconditioning group (P<0.05).Conclusion: Myo-cardial ischemic preconditioning has a protective effect on myocardial , and there is significant effect on the protection of heart function, reduce myocardial injury and reduce the complications after treatment .