摘要
目的 观察缺血预适应对初次心肌梗死溶栓再通患者的影响。方法 5 7例溶栓再通患者按心肌梗死前 2 4小时内有无心绞痛发作分为缺血预适应组 2 6例 ;对照组 31例 ,两组临床情况相似 ,观察再灌注心律失常 ,CK-MB酶峰 ,射血分数及并发症等情况。结果 缺血预适应组再灌注心律失常发生率 (46 .15 % )低于对照组 (74.19% ,P<0 .0 5 ) ,住院期间严重心律失常发生率 (15 .38% )也低于对照组 (41.94% ,P<0 .0 5 ) ,梗死后心绞痛发生率 (2 3.0 8% )低于对照组 (48.39% ,P<0 .0 5 ) ,而射血分数高于对照组 (6 0± 7.9) %与 (5 4± 9.3) % ,P<0 .0 5。两组间 CK-MB峰值 [(4.89± 0 .33)μmol· s- 1 / L和 (5 .13± 0 .39)μmol· s- 1 / L ) ] ,心力衰竭发生率 (3.85 %与 3.2 3% ) ,两组比较心源性休克发生率 (7.6 9%与 6 .45 % )无显著差异常 ,P均大于 0 .0 5。结论 缺血预适应可能保护心脏 ,改善射血分数 ,减少心律失常的发生 ,但并没有减少心肌梗死的面积。
Objective To observe the effects of preconditioning on patients of acute myocardial infarction with successful thrombolysis.Methods 57 cases with similar clinical indications were divided into 2 groups:ischemia preconditioning group (n=26) and the control group (n=31).Their reperfusion arrhythmias,peak value of CK-MB,rejection fraction and complications were recorded.Results The incidences of reperfusion arrhythmias,serious arrhythmia during hospitalization and post-infarction angina in the treatment group were all lower than those in the control group (46.15% vs 74.19%;15.38% vs 41.94%;23.08% vs 48.39% respectively,P<0.05).But the ejection fraction was higher in the teatment group than in the control group[(60±7.9)% vs (54±9.3)%,P<0.05].About the peak value of CK-MB,the incidence of heart failure and the cardiac shock in both groups,there were no differences (P>0.05).Conclusion The ischemia preconditioning may protect myocardium,improve ejection fraction and reduce the incidence of arrhythmias,but can not reduce the size of myocardial infarction.
出处
《中国综合临床》
2000年第10期737-738,共2页
Clinical Medicine of China
关键词
缺血预适应
急性心肌梗死
治疗
溶栓疗法
Ischemia preconditioning Acute myocardial infarction Angina pectoris Arrhythmia
