【摘要】 目的　为探讨心绞痛对心肌梗塞后心功能的影响。方法　对 1 4 5例急性心肌梗塞 (AMI)患者临床回顾性分析 ,阐明梗塞前心绞痛 (PAP)对心肌梗塞范围、梗塞后并发症及恶性心律失常等方面所起的作用。结果　PAP组有较少坏死Q波数 (P <0 0 1 )和异常室壁运动个数 (P <0 0 5) ,有显著降低的CK和CK MB峰值 (P <0 0 1 ) ,左室和右室射血分数也较高 (P <0 0 5)。住院期间心功能不全发生率明显下降 ,2 4小时内室性早搏、室性心动过速、室颤和房室传导阻滞发生率明显降低 (P <0 0 1 ) ,而左室高峰充盈率 (LVPFR)和侧支循环相比较无明显差异。提示 :PAP具有缩小心肌梗塞范围 ,保护心脏收缩功能 ,抗恶性心律失常的作用。对心脏舒张功能、房颤、梗塞后心绞痛和室壁瘤等可能无保护作用。更多还原

【Abstract】 By the clinical analysis of a total of 145 consecutive patients with AMI,we found that the presence of angina before AMI may have effects on the infarct size,the incidence of postinfarction complications and arrhythmias The main results were as follows:in contrast to control group,we found that PAP group had fewer numbers of necrotic Q waves ( P <0 01) and the numbers of abnormal wall motion ( P <0 05);The peak values of CK and CK MB were significantly decreased ( P <0 01);left and right ventricular ejection fraction were higher ( P <0 05) There were lower incidences of the in hospital cardiac dys function and 24 hour ventricular premature beats,ventricular tachycardia,ventricular fibrillation and atrioventricular block (all P <0 01) The results suggested the PAP may limited the infarct size,preserve the cardiac systolic function and abolish the life threatening arrhythmias更多还原