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心肌缺血预适应(Ischemic Preconditioning,IP)现象是一种心肌自我保护的机制, 其最早定义是指一次短暂心肌缺血的快速适应反应可减慢随后长时间心肌缺血所致的细胞坏死速度. 近年动物实验及临床研究表明, 梗塞前有心绞痛患者其住院病死率、严重心衰、休克发生率均较对照组低. IP不仅能缩小心肌梗塞心肌坏死范围, 还可降低室性心律失常的发生率及严重程度, 改善左室功能. 本文通过对135例AMI患者的观察分析, 探讨IP对其近期愈后的影响. 1 对象与方法1.1 对象 选择1993年1月～1998年1月的AMI患者病例135例(24小时后入院者除外),其中男性87例, 女性48例, 年龄36岁～85岁, 所有病历均符合1979年WHOAMI诊断标准,将病例分为有IP和无IP两组:①IP组指AMI前 48小时内有心绞痛发作者;②无IP组指AMI前无上述表现;③两组患者入院时情况比较(见表1).
Ischemic Preconditioning (IP) is a mechanism of myocardial self-protection. Its earliest definition is that a rapid adaptation reaction of transient myocardial ischemia can slow down the necrosis of cells caused by prolonged myocardial ischemia In recent years, animal experiments and clinical studies have shown that in patients with angina before infarction, their in-hospital mortality, severe heart failure, shock rates were lower than the control group.IP can not only narrow the scope of myocardial infarction myocardial necrosis, but also reduce ventricular arrhythmia Incidence and severity, improve left ventricular function.This article through the analysis of 135 cases of AMI patients to explore the impact of IP on the prognosis of the recent 1. Subjects and methods 1.1 object selection January 1993 ~ January 1998 AMI There were 135 patients (except admission after 24 hours), including 87 males and 48 females, ranging in age from 36 to 85 years. All medical records were in accordance with the WHOAMI criteria of 1979. The cases were divided into two groups: IP and no IP : ①IP group refers to patients with angina pectoris within 48 hours before AMI; ② no IP group refers to the above performance before AMI; ③Comparison of the two groups when admitted to hospital (Table 1).