远隔缺血后适应对急性ST段抬高型心肌梗死患者的心肌保护作用

发布时间：2018-11-15 16:46

【摘要】：目的探讨肢体远隔缺血后适应(RIPost C)对急性ST段抬高型心肌梗死(STEMI)患者心肌缺血再灌注损伤的影响。方法选择STEMI并在心导管室行急诊直接经皮冠脉介入治疗(PPCI)患者80例。随机分为PPCI+RIPost C组(n=36)和PPCI组(n=44),两组均接受PPCI。PPCI+RIPost C组在球囊扩张3 min内针对上肢行RIPost C。受试者术前和术后0.5、8、24、48、72 h共抽取静脉血6次测定血清肌酸磷酸激酶同工酶(CK-MB)浓度。术后第7天应用心脏超声评估左心室射血分数(LVEF)。结果(1)PPCI+RIPost C组CK-MB峰值明显减低〔(280.60±45.83)ng/ml vs(352.21±65.42)ng/ml,P0.01〕;PPCI+RIPost C组CK-MB曲线下面积中位数为717.25(364.63~921.98),PPCI组曲线下面积中位数为807.00(693.30~1 136.00),PPCI+RIPost C组较PPCI组CK-MB曲线下面积明显减低(P0.05)。(2)PPCI+RIPost C组术后第7天LVEF显著高于PPCI组〔(54.50±9.73)%vs(48.14±7.04)%,P=0.01〕。结论针对上肢行RIPost C可以降低STEMI患者心肌坏死面积、提高患者LVEF,提示RIPost C对STEMI患者心肌缺血再灌注损伤有保护作用。
[Abstract]:Objective to investigate the effects of limb adaptation to (RIPost C) on myocardial ischemia-reperfusion injury in patients with acute ST segment elevation myocardial infarction (STEMI). Methods 80 patients with (PPCI) were treated with STEMI and direct percutaneous coronary intervention in cardiac catheterization. PPCI RIPost C group (nong36) and PPCI group (nong44) were randomly divided into two groups. Both groups received RIPost C in PPCI.PPCI RIPost C group for upper limb during 3 min balloon dilatation. Serum creatine phosphokinase isoenzyme (CK-MB) concentration was measured 6 times before and after operation of 0. 5 and 0. 5 minutes after operation for 72 h. The serum creatine phosphokinase isoenzyme (CK-MB) concentration was measured. Evaluation of left ventricular ejection fraction (LVEF).) by echocardiography on the 7th day after operation Results (1) the peak value of CK-MB in) PPCI RIPost C group was significantly decreased (280.60 卤45.83) ng/ml vs (352.21 卤65.42) ng/ml,P0.01); The median area under the CK-MB curve of PPCI RIPost C group was 717.25 (364.63), PPCI 921.98), and the median area under the suites was 807.00 (693.30 卤1 136.00). The area under CK-MB curve in PPCI RIPost C group was significantly lower than that in PPCI group (P0.05) LVEF in) PPCI RIPost C group was significantly higher than that in PPCI group on the 7th day after operation (54.50 卤9.73)% vs (48.14 卤7.04)%, P0.01). Conclusion RIPost C can reduce the area of myocardial necrosis in patients with STEMI, and increase the LVEF, of patients with LVEF, suggesting that RIPost C has protective effect on myocardial ischemia-reperfusion injury in STEMI patients.
【作者单位】：苏州大学附属第一医院心内科;
【基金】：国家自然科学基金(81170173)
【分类号】：R542.22

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