心脏缺血后适应减轻急性心肌梗死再灌注损伤临床研究Reduction in myocardial infarction by postconditioning in patients during primary coronary angioplasty
杨新春,刘宇,王乐丰,葛永贵,王红石,李惟铭,徐立,崔亮,徐琳,王铁,刘胜辉,贾慧敏
摘要(Abstract)：
目的探讨缺血后适应的心肌保护作用。方法41例首次发生急性心肌梗死的患者随机分入对照组(n=18)和缺血后适应组(n=23)。各例接受急诊PTCA治疗。对照组梗死血管再通后3min内不施加干预;缺血后适应组梗死血管再通后1min内应用低气压充盈和回撤球囊,每一过程各30s。术后观察梗死血管TIMI血流、心肌Blush分级、72h内肌酸磷酸激酶(CK)、术后2hST段回落,出院前左心室射血分数等指标,与对照组进行比较。结果术后2hST段回落、梗死血管TIMI血流、心肌Blush分级两组差异无统计学意义。缺血后适应组72h内CK平均值连线的曲线下面积显著减低(58002比79787,P=0.04)。结论急诊PTCA缺血后适应过程能够通过减少心肌梗死面积减轻再灌注损伤,提供心肌保护作用。
关键词(KeyWords)： 心肌梗死;心肌再灌注损伤;后适应
基金项目(Foundation):
作者(Author): 杨新春,刘宇,王乐丰,葛永贵,王红石,李惟铭,徐立,崔亮,徐琳,王铁,刘胜辉,贾慧敏
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