Objective To study whether ischemic postconditioning can effectively reduce ischemia/reperfusion (I/R)injury in acute myocardial infarction (AMI)patients .Methods Forty-two AMI patients admitted to our hospital were randomly divided into control group (n=22) and ischemic postconditioning group (n=20) .CK-MB value and average area under CK-MB curve were meas-ured before and 2 h ,1 ,2 ,3 days after PCI .Serum levels of CRP ,MDA and SOD were measured before and 2 h after PCI .ST segment falls on ECG were compared before and 24 h after PCI .Ma-lignant arrhythmia in the patients was recorded during their hospital stay .Results The peak CK-MB value ,average area under CK-MB curve ,serum levels of CRP and MDA were significantly lower while the serum SOD level was significantly higher in ischemic postconditioning group than in control group after PCI (P<0 .05 ,P<0 .01) .The ST segment fall was faster in ischemic post-conditioning group than in control group .Two patients in control group died of malignant ar-rhythmia .Conclusion Ischemic postconditioning can reduce the CK-MB release ,oxygen free radi-cal level ,inflammatory reaction ,I/R injury and restore coronary blood flow in AMI patients ,thus playing a role in protecting the heart .%目的：探讨急性心肌梗死（AMI）患者施行缺血后适应能否有效地降低缺血再灌注损伤，从而对心脏产生保护作用。方法选取AMI患者42例，随机分为对照组22例和缺血后适应组20例。监测2组患者PCI术前、术后2h、1、2、3d内肌酸激酶同工酶（CK-MB）值，并测定CK-MB峰值及各时间点下CK-MB平均值曲线下面积；监测PCI术前及术后2h血清C反应蛋白（CRP）、丙二醛和超氧化物歧化酶（SOD）水平；比较2组患者PCI术前及术后24h内心电图ST段回落情况。结果缺血后适应组CK-MB峰值明显低于对照组[（570．61±41．27）U/Lvs（661．80±58．55）U/L，P＜0．01]；CK-MB平均值曲线下面积明显低于对照组[（5821．19±2912．07）％vs（9843．12±3578．02）％，P＜0．01]；缺血后适应组术后2hCRP下降幅度明显低于对照组（P＜0．05）；缺血后适应组术后丙二醛下降较对照组明显（P＜0．05）；缺血后适应组术后SOD升高较对照组明显（P＜0.01）；缺血后适应组ST段回落情况较对照组高（60．0％vs45．5％，P＜0．05），对照组中有2例患者因发生恶性心律失常死亡。结论AMI患者施行缺血后适应处理能够降低CK-MB的释放，降低氧自由基含量，减轻炎性反应，使冠状动脉恢复血流情况占有明显优势，能够明显降低再灌注损伤，发挥心脏保护作用。
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