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目的分析缺血后处理对急性ST段抬高型心肌梗死再灌注损伤的保护作用。方法选择2009年6月-2010年12月来我院心内科诊治的STEMI患者98例,根据处理方式的不同分为观察组和对照组各49例,对照组采用单纯再灌注治疗,观察组进行缺血后处理,对比两组患者心功能情况、心肌梗死面积等。结果术后观察组和对照组ST段完全回落率分别为81.63%、55.10%;心律失常发生率分别为22.45%、61.22%;左室射血分数分别为(0.73±0.07)%、(0.45±0.09)%;心肌梗死面积分别为(9.87±5.32)%、(15.11±7.12)%;发病72h内CK峰值分别为(1159.54±538.32)U/L、(1698.87±521.32)U/L,观察组的各项指标均优于对照组,差异均具有统计学意义(P<0.05)。两组患者术后ES、SS均有不同程度减小,较术前差异均具有统计学意义(P<0.05);术后观察组的ES、SS均低于对照组,差异均具有统计学意义(P<0.05)。结论缺血后处理可明显减轻STEMI患者的心肌缺血再灌注损伤程度,保护再灌注的心肌组织,值得临床推广应用。
Objective To analyze the protective effect of ischemic postconditioning on reperfusion injury in acute ST segment elevation myocardial infarction. Methods From June 2009 to December 2010, 98 patients with STEMI who were treated by our department were divided into observation group and control group with 49 cases in each group. The control group was treated with reperfusion and the observation group Ischemic postconditioning, compared with two groups of patients with cardiac function, myocardial infarction area. Results The complete recovery rates of ST segment in observation group and control group were 81.63% and 55.10% respectively. The incidences of arrhythmia were 22.45% and 61.22% respectively. The left ventricular ejection fraction were (0.73 ± 0.07)% and (0.45 ± 0.09)%, and the myocardial infarct size was (9.87 ± 5.32)% and (15.11 ± 7.12)% respectively. The peak values of CK within the first 72 h were (1159.54 ± 538.32) U / L and (1698.87 ± 521.32) U / Of the indicators were better than the control group, the differences were statistically significant (P <0.05). The ES and SS of the two groups were decreased to some extent after operation, which were significantly different from the preoperative values (P <0.05). The ES and SS of the postoperative observation group were lower than those of the control group, the differences were statistically significant (P <0.05). Conclusion Ischemic postconditioning can significantly reduce the degree of myocardial ischemia-reperfusion injury in STEMI patients and protect the reperfusion myocardium, which is worthy of clinical application.