【摘要】 目的探讨缺血后适应(IPOC)能否减少65岁以下且总缺血时间<6 h的急性ST段抬高型心肌梗死(STEMI)患者的心肌梗死面积,改善患者心功能。方法将122例患者随机分为观察组(62例)和对照组(60例)。其中对照组采用IPOC干预。观察两组患者经皮冠状动脉介入治疗(PCI)术后心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)峰值、3个月后心脏彩超左心射血分数(LVEF)、左室舒张末期容积(LVEDD)、6个月后心脏磁共振(CMR)心肌梗死面积大小有无差异。结果两组患者PCI术前cTnI、CKMB值比较,差异无统计学意义(P>0.05);但PCI术后,观察组cTnI、CK-MB峰值明显低于对照组(P<0.05);术后3个月,观察组LVEF、LVEDD明显优于对照组(P<0.05)。PCI术后6个月,CMR测得梗死面积观察组明显低于对照组(P<0.05)。结论 IPOC能够减少65岁以下总缺血时间小于<6 h的急性STEMI患者的心肌梗死面积,改善心功能。更多还原

【Abstract】 Objective To investigate whether ischemic postconditioning(IPOC) can reduce infract size and improve ventricular function in acute ST-segment elevation myocardial infraction(STEMI) patients under 65 years of age and total ischemic time was less than 6 hours. Methods A total of 136 patients were randomly divided into IPOC group and control group. Cardiac troponin I(cTnI) peaks and creatine kinase-MB(CK-MB) peaks after PCI, left ventricular ejection fraction(LVEF) and left ventricular end-diastolic dimension(LVEDD) after three months, infarct size measured by cardiac magnetic resonance after 6 months were recorded and the results were compared between the two groups. Results There was no significant difference in cTnI and CK-MB values before PCI(P>0.05) between two groups. However, the cTnI peak and CK-MB peak values of IPOC group were remarkably lower than those of the control group(P<0.05). At the time of admission, there was no significant difference in the LVEF and LVEDD values between the two groups, but three months after PCI the LVEF and WMSI values of IPOC group were significantly better than those of the control group(P<0.05). Infarct size 6 months after PCI in IPOC group was obviously lower than that in the control group(P<0.05).Conclusion IPOC can reduce infract size and improve ventricular function in acute STEMI patients under 65 years of age and total ischemic time was less than 6 hours.更多还原