心肌缺血预适应对初发急性非ST段抬高型心肌梗死患者近期预后的影响

发布时间：2018-04-09 04:38

本文选题：急性非ST段抬高型心肌梗死　切入点：心肌缺血预适应　出处：《山东医药》2016年38期

【摘要】：目的观察心肌缺血预适应(MIP)对初发急性非ST段抬高型心肌梗死(NSTEMI)患者近期预后的影响。方法选取208例初发NSTEMI入院患者,其中急性心肌梗死前无MIP 88例(无MIP组),存在MIP 120例(MIP组),对比分析两组临床资料及近期预后情况。结果与无MIP组比较,MIP组血清心肌肌钙蛋白T、肌酸激酶同工酶峰值较低(P0.01)。MIP组不良心血管事件总发生率为27.5%,其中室性心动过速(VT)/心室颤动(VF)为3.3%、心力衰竭16.7%、再发心肌梗死2.5%、30 d心血管死亡10.8%;无MIP组不良心血管事件总发生率为40.9%,其中VT/VF为11.3%、心力衰竭33.0%、再发心肌梗死4.5%、30 d心血管死亡13.6%;与无MIP组比较,MIP组VT/VF、心力衰竭及不良心血管事件总发生率降低(P均0.05)。Logistic回归分析发现,MIP是VT/VF(OR 0.27,95%CI 0.08~0.89,P=0.031)、心力衰竭(OR 0.41,95%CI 0.21~0.78,P=0.007)和总体心血管不良事件(OR0.55,95%CI0.31~0.98,P=0.043)的显著预测因子。结论 MIP可改善初发NSTEMI入院患者的近期预后,包括减小心肌梗死面积,减少VT/VF和心力衰竭的发生。
[Abstract]:Objective to observe the effect of myocardial ischemic preconditioning (MIP) on the short term prognosis of patients with acute non-St segment elevation myocardial infarction (NSTEMI).Methods two hundred and eighty-eight patients with primary NSTEMI were enrolled in this study. 88 patients without MIP before acute myocardial infarction (no MIP group and 120 patients with MIP) were enrolled in this study. The clinical data and short-term prognosis of the two groups were compared and analyzed.Results compared with no MIP group, the total incidence of adverse cardiovascular events in the MIP group was 27.50.The total incidence of adverse cardiovascular events in the MIP group was 27.50.The ventricular tachycardia (VTT) / ventricular fibrillation (VF) was 3.3%, heart failure was 16.7cm, and the incidence of recurrent myocardial events in the MIP group was 27.50.The ratio of ventricular tachycardia to ventricular fibrillation was 3.3cm, heart failure was 16.7cm, and the incidence of adverse cardiovascular events was 27.5%.The total incidence of adverse cardiovascular events in the non-MIP group was 40.9, in which VT/VF was 11.3, heart failure was 33.0, and myocardial infarction was 4.5 days later, the cardiovascular death was 13.60.Compared with the non-MIP group, VT / VF, heart failure and adverse cardiovascular events were found in the non-MIP group.Conclusion MIP can improve the short term prognosis of patients with initial NSTEMI, including reducing myocardial infarction size, VT/VF and heart failure.
【作者单位】：同济大学附属第十人民医院;上海市杨浦区市东医院;
【分类号】：R542.22

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