心肌缺血预适应对急性心肌梗塞近期预后的影响

目的:对首次急性心肌梗塞(AMI)发生前48h内是否发作过心绞痛的二组患者的临床经过和近期预后进行评价.方法:208例患者分为缺血预适应组(122例),无预适应组(86例),两组基础临床情况类似.结果:缺血预适应组比非缺血预适应组临床经过近期预后好,心肌梗塞范围小(P<0.001),血浆肌酸磷酸激酶峰值低(P<0.01),住院期间发生心衰、心源性休克、严重心律失常、心源性死亡率低(P<0.01).结论:急性心肌梗塞前48h内发作的心绞痛对心肌具有明确的保护作用,其机理可能和心肌缺血预适应有关.

Effects of ischemic preconditioning on short-termprognosis of acute myocardial infarction

Objective: To evaluate the clinical courses and short-term prognosis of 2 groups of the first acute myocardial infarction (AMI). one with angina in 48 hours before AMI and the an other not. Methods Two hundred and eight cases of first AMI were divided into 2 groups: Ischemia Preconditioning (IP) group(n = 122) .angina occurred wihthin 48 hours before AMI onset; no Ischemia Preconditioning (NIP) group (N = 86), no angina occurred. The basic clinical characteristics of the 2 groups were similar. Results The infarction size was smaller in the IP group that than those in the NIP group (P<0. 001). The peak value of CPK was lower in the IP than that in the NIP group (P<0. 01) The incidences of heart failure cardiogenic shock serious arrhythmia and cardio-genie mortality during hospitalization were also lower in the IP than those in the NIP group (P<0. 01). Conculusion: The angina within 48 hours before AMI onset had definite cardioprotective effect. These favorable effects of angina were related to the ischemia preconditioning.