【摘要】 目的　探讨延迟心肌预缺血对急性心肌梗死 (AMI)临床表现与近期预后的影响。方法　回顾性分析397例心绞痛 (心绞痛组 )病程大于 2周的AMI患者临床资料 ,与 371例无心绞痛史的AMI患者 (对照组 )比较。结果　心绞痛组合并休克、心衰者少于对照组 (分别为 1 0 .6 %对 1 6 .8%和 1 8.9%对 2 5 .9% ,P <0 .0 5 ) ,住院病死率也较低(1 0 .6 %对 1 6 .9% ,P <0 .0 5 ) ,肌酸激酶峰值较低 [(783± 4 83)U/L对 (1 0 86± 5 4 3)U/L ,P <0 .0 1 ],心绞痛组梗死前正规治疗者多于对照组 (6 8.8%对 2 8.6 % ,P <0 .0 0 1 ) ,但多部位梗死较少 (1 6 .4 %对 2 2 .3% ,P <0 .0 0 1 )。结论　与无心绞痛发作的患者比较 ,急性心肌梗死前有延迟心肌预缺血的冠心病患者梗死面积小 ,心源性休克及充血性心衰发生率低。更多还原

【Abstract】 Objective To investigate the effect of delay ischemic preconditioning on the clinical feature and short term prognosis after acute myocardial infarction (AMI). Methods The clinical data were analyzed retrospectively in 397 AMI patients with two weeks or more of previous angina pectoris (AP)(AP group), and compared with those 371 cases of control subjects without AP(control group).Results Compared with control group, the AP group had fewer incidences of shock, heart failure and inhospitalized mortality ( 10.6 % vs 16.8 %, 18.9 % vs 25.9 % and 10.6 % vs 16.9 %, respectively, all P< 0.05 ). AP group had a higher rate of regularly medications before admission ( 68.8 % vs 28.6 %, P< 0.001 ). Multifocal infarctions were less and the peak levels of cretinine kinase were lower in AP group than those in control group [ 16.4 % vs 22.3 %, P< 0.001 ; (783±483) U/L vs (1086±543) U/L, P< 0.01 ].Conclusion Compared with patients without AP, AMI patients with delay ischemic preconditioning have samll size infarction ,lower incidence of shock and heart failure.更多还原