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心肌梗死前心绞痛持续时间对患者状况及预后的影响

Effect of angina cordis before acute myocardial infarction on prognosis of patients
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摘要 目的 探讨心肌梗死 (AMI)前心绞痛持续时间对急性AMI患者临床状况及近期预后的影响。方法 选择 197例确诊为急性AMI的患者 ,按梗死前 48h内心绞痛持续时间长短分成三组。Ⅰ组持续时间 <15min ,Ⅱ组 >15min ,Ⅲ组 48h内无心绞痛发作。通过对三组患者的梗死范围、肌酸激酶(CK)峰值、左室射血分数 (LVEF)及各组间恶性室性心律失常、心源性休克、心衰等心脏事件的发生率和病死率进行比较。结果 Ⅰ组患者状况及近期预后明显优于其他两组。Ⅰ组与Ⅱ、Ⅲ组比较差异有显著性 (P <0 .0 1或P <0 .0 5 ) ,Ⅱ组与Ⅲ组比较差异无显著性 (P >0 .0 5 )。结论 梗死前短暂的心绞痛对心肌具有缺血预适应保护作用 ,但是反复短暂的心肌缺血对心肌具有缺血叠加效应 ,只有梗死前有短时间 ( <15min) Objective To investigate the effects of continuous time of angina corids before acute myocardial infaction (AMI) on condition and short term prognosis of patients with AMI.Methods 197 cases of AMI were divided into three groups according to continuous time of angina cordis in 48 hours before AMI.The time of first group was less than 15 minutes,that of second group was more than 15 minutes and there was no attack of angina cordis in 48 hours in the third group.The infarction scope,CK peak value and LVEF were observed,and the morbidity and mortality of serious ventricular arrhythmia,cardiogenic shock and heart failure were compared.Results The condition and short term prognosis in first group was much better than the other two groups,there were significant differences between first group and second,third group (P<0.01 or P<0.05),there was no significant diffrences between second group and third group.Conclusion The short time angina cordis had protect effect of ischemic preconditioning on myocardium,but repeated short myocardial ischemia had ischemic accumulation effect on myocardium,only the ischemia stimulas whose time was less than 15 minutes had the protect effect..
出处 《河北医药》 CAS 2001年第9期653-654,共2页 Hebei Medical Journal
关键词 心肌预适应 心肌缺血叠加效应 心绞痛 心肌梗塞 myocardial infaction ischemic preconditioning myocardial ischemia accumulation effect angina cordis before AMI
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