闫华, 李莉, 刘晓坤, 赵碧琼, 田美荣, 姜玉茹, 尚小明. 缺血后适应对急性心肌梗死经皮冠状动脉介入治疗术中心肌的保护作用[J]. 心脏杂志, 2009, 21(2): 236-238.
    引用本文: 闫华, 李莉, 刘晓坤, 赵碧琼, 田美荣, 姜玉茹, 尚小明. 缺血后适应对急性心肌梗死经皮冠状动脉介入治疗术中心肌的保护作用[J]. 心脏杂志, 2009, 21(2): 236-238.
    Cardioprotection of ischemic postcondition for patients with acute myocardial infarction during percutaneous coronary intervention[J]. Chinese Heart Journal, 2009, 21(2): 236-238.
    Citation: Cardioprotection of ischemic postcondition for patients with acute myocardial infarction during percutaneous coronary intervention[J]. Chinese Heart Journal, 2009, 21(2): 236-238.

    缺血后适应对急性心肌梗死经皮冠状动脉介入治疗术中心肌的保护作用

    Cardioprotection of ischemic postcondition for patients with acute myocardial infarction during percutaneous coronary intervention

    • 摘要: 目的 探讨心肌缺血后适应对急性心肌梗死经皮冠状动脉介入治疗术(PCI)中心肌的保护作用。方法 选择首次发生急性心肌梗死的患者105例,随机分为观察组(缺血后适应组)及对照组,均接受急诊PCI。对照组行常规PCI;观察组PCI术中设置缺血后适应方式。测定两组术前及术后肌酸激酶(CK)及肌酸激酶同工酶(CK-MB)水平;测量术后左心室舒张期末容积指数(LVEDVI)、左心室收缩期末容积指数(LVESVI)、左心室射血分数(LVEF);观察术后严重心律失常、梗死后心绞痛、住院期间病死率发生情况。结果 与对照组比较,观察组术后CK及CK-MB峰值水平明显减低;术后3个月左心室容积减小, LVEDVI [(64±6)ml/m2 vs (67±6)ml/m2,P<0.05],LVESVI[(30±4)ml/m2 vs (34±4)ml/m2,P<0.05],LVEF升高(0.53±0.02 vs 0.50±0.03,P<0.05);严重心律失常、梗死后心绞痛明显减低,差异有统计学意义(P<0.05);住院期间病死率的差异未达到显著水平。结论 心肌缺血后适应对急性心肌梗死PCI术中心肌有保护作用。

       

      Abstract: AIM To evaluate the cardioprotection of ischemic postcondition for patients with acute myocardial infarction during percutaneous coronary intervention. METHODS A total of 105 patients with AMI were enrolled the study, 54 patients were in ischemic postconditioning (PC) group and 51 patients in non-ischemic postconditioning (NPC) group. The level of plasma CK and CK-MB was detected and the indices of left ventricular end diastolic volume index, left ventricular end systolic volume index and left ventricular ejection fraction were measured by ultrasonic cardiogram after the onset of AMI. Malignant arrhythmia, angina occurred after AMI and death rate in hospital were compared between the two groups. RESULTS The peak level of plasma CK and CK-MB were higer in NPC group compared with those in PC group (P<0.05). The parameters of cardiac performance decreased significantly in PC group compared with those in NPC group. Significant difference was found in left ventricular end diastolic volume index [(64±6)ml/m2 vs (67±6 )ml/m2, P<0.05], left ventricular end systolic volume index [(30±4)ml/m2 vs (34±4)ml/m2, P<0.05] and left ventricular ejection fraction (0.53±0.02 vs 0.50±0.03, P<0.05) in PC group 3 months after PCI. The incidence of malignant arrhythmia and angina after AMI were lower in PC group compared with that in NPC group (P<0.05) while the difference in the death rate in hospital was not significant between the two groups. CONCLUSION Ischemic postcondition has some cardioprotection for patients with acute myocardial infarction during percutaneous coronary intervention.

       

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