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目的 观察心肌缺血预适应对急性心肌梗死左室功能的影响。方法 5 2例无并发糖尿病的急性心肌梗死患者按发病前 4 8h有无心绞痛分为有心肌缺血预适应 (A)组和无心肌缺血预适应 (B)组。应用超声心动图及彩色多普勒技术检测各组左室射血分数 (LVEF)、每搏输出量 (SV)、心输出量 (CO)及二尖瓣口E峰、A峰、E/A、E峰流速积分 (VTIE)、A峰流速积分 (VTIA)、VTIE/VTIA,并与对照 (C)组进行比较。结果 ①A、B二组的LVEF、SV下降 ,与C组比较差异有统计学意义 ,其中B组较A组下降更明显 ,二组间比较差异有统计学意义 ;CO下降不明显。②A、B二组E峰及VTIE 下降 ,E/A、VTIE/VTIA 减低 ,与C组比较差异有统计学意义 ,其中B组与A组比较有统计学意义 ;A峰及VTIA 增大 ,B组升高更明显 ,与C组比较有统计学意义。结论 急性心肌梗死后左室收缩及舒张功能均减低 ,有心肌缺血预适应组较无心肌缺血预适应组减低程度较小 ,提示心肌缺血预适应对急性心肌梗死左室功能有保护作用
Objective To observe the effect of myocardial ischemic preconditioning on left ventricular function in patients with acute myocardial infarction. Methods Fifty-two patients with acute myocardial infarction without concomitant diabetes were divided into two groups: preconditioning with myocardial ischemia (group A) and preconditioning without myocardial ischemia (group B) according to the presence or absence of angina pectoris at 48h before onset. The left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO) and mitral E, A and E / A were detected by echocardiography and color Doppler imaging , E peak velocity integral (VTIE), A peak velocity integral (VTIA), VTIE / VTIA, and compared with the control (C) group. Results ① The LVEF and SV decreased in group A and group B, and there was significant difference between group B and group C. The difference between group B and group A was statistically significant. There was no significant difference in CO between the two groups. ② The peak E and VTIE of group A and group B decreased, while the ratio of E / A and VTIE / VTIA decreased. There was a significant difference between group A and group B Group increased more significantly, compared with the C group was statistically significant. Conclusions Left ventricular systolic and diastolic function decreased after acute myocardial infarction. Compared with myocardial ischemic preconditioning group, myocardial ischemic preconditioning group had less reduction, suggesting that myocardial ischemic preconditioning has a protective effect on left ventricular function in acute myocardial infarction