摘要
目的:梗死前心绞痛(PA)可促使缺血预适应(IP)产生,本文旨在探讨PA对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入(PCI)术后近期预后的影响。方法:选择首次罹患STEMI患者73例,其中33例梗死前无心绞痛作为无PA组,40例梗死前48h内出现心绞痛作为PA组,均于发病12h内行急诊PCI治疗,动态监测血清肌酸激酶同工酶(CK-MB),采用计算机辅助冠状动脉造影(CAG)明确冠状动脉的狭窄程度及病变支数,比较两组住院期间临床预后与术后6个月临床预后。结果:PA组CK-MB峰值234.08±120.41U/L明显低于无PA组409.18±113.22U/L(P<0.01)。PA组冠状动脉病变支数少于无PA组,但比较无明显差异(P>0.05)。PA组术后主要心脏不良事件、再梗死的发生率明显低于无PA组,左室射血分数(LVEF)明显高于无PA组(P<0.05)。PA组总体近期临床预后优于无PA组。结论:PA可通过IP的心肌保护机制减小STEMI患者的心肌损伤程度,减少冠状动脉的狭窄程度与病变支数,对患者近期预后有显著的改善作用。
Objective ：Preinfarction angina （PA ） can cause ischemic preconditioning ,and the aim at researching of short-time prognosis of PA in patients complicated with STEMI after percutaneous coronary intervention .Methods ：73cases patients with STEMI were selected ,and were divided into the non-PA group（n= 33）and the PA group（n= 40） .All the patients were underwent emergency PCI within 12h after onset ,and serum creatine kinase isoenzyme （CK-MB）were dynamic monitored ,and coronary artery stenosis degree and the lesion counts were examined by coronary angiography combined with computer .The short-time prognosis of two groups were compared .Results ：The peak of CK-MB of the PA group （ 234 .08 ± 120 .41U /L） was significantly lower than the non-PA group （409 .18 ± 113 .22U /L）（P〈 0 .01） .The coronary artery lesions counts of the PA group were less than the non-PA group ,but the difference was no significant （P〉0 .05） .The incidence rate of the major adverse cardiac events and reinfarction of the PA group were lower than the non-PA group（P 〈 0 .05） ,and the short-time prognosis of the PA group was better than the non-PA group generally .Conclusion ：Through the mechanism of IP for myocardial protection ,PA can reduce the myocardial damage degree of STEMI patients ,and reduce the coronary artery stenosis degree and the lesion counts ,which can improve the short-time prognosis significantly .
出处
《陕西医学杂志》
CAS
2016年第12期1586-1588,共3页
Shaanxi Medical Journal
基金
辽宁省教育厅项目(2010641
LS2010169)
关键词
心绞痛
心肌梗塞
@PCI
预后
Angina pectoris
Myocardial infarction
@PCI
Prognosis
