梗死前心绞痛对急性心肌梗死患者直接经皮冠状动脉介入治疗术后的影响

目的　探讨梗死前心绞痛对首次急性心肌梗死(AMI)患者直接经皮冠状动脉介入治疗(PCI)术后的近期影响。方法　将120例首次AMI患者分成有梗死前心绞痛史组(A组, 68例)和无梗死前心绞痛史组(B组, 52例),在发病12小时内行直接PCI术,分析梗死前心绞痛对肌酸肌酶(CK)峰值浓度、左心室功能和临床转归的影响。结果　(1)A组CK及CK MB峰值浓度均显著低于B组(P<0. 05); (2)A组冠状动脉自发再通率高于B组(P<0. 05),A组无再流现象发生率低于B组(P<0. 05); (3)A组左室射血分数高于B组(P<0. 05); (4)A组心力衰竭发生率及再梗死率低于B组(P<0. 05)。结论　梗死前心绞痛可能促进AMI患者梗死相关动脉自发再通的发生,减少直接PCI术后无再流现象发生,改善患者左心室功能和临床预后。

Effects of preinfarction angina on patients with acute myocardial infarction after direct percutaneous coronary intervention

Objective To investigate the short-term influences of preinfarction angina on patients with first acute myocardial infarction(AMI)after direct percutaneous coronary intervention(PCI).Methods One hundred and twenty patients with first AMI were underwent direction of PCI within 12 hours after onset of AMI.The relations of preinfarction angina to peak creatine kinase (CK),left ventricular function and clinical significance were analyzed.Results (1)In 120 patients,there were 68 case with preinfarction angina (group A) and 52 case without preinfarction angina (group B).(2)The peak CK and CK-MB in group A were lower than those in group B(P<0.05).(3)The incidence of spontaneous coronary recanalization(SR) of infarct related artery(IRA) in group A was higher than that in group B(P<0.05);The incidence of no-reflow phenomenon in group A was lower than that in group B(P<0.05).(4)LVEF in group A was higher than that in group B(P<0.05).(5)The incidence of heart failure and reinfarction in group A were lower than that in group B(P<0.05).Conclusion Preinfarction angina has beneficial effects on SR of IRA and can inhibit no-reflow phenomenon after direct PCI and improve left ventricular function and short-term prognosis in AMI patients.