摘要：
目的 研究心肌缺血预适应对急性心肌梗死尿激酶溶栓患者心肌功能的保护作用.方法 选取2012年3月至2015年3月90例急性心肌梗死尿激酶溶栓患者为研究对象,48 h内有心绞痛的患者纳入观察组(n=47),24 h内无心绞痛的患者纳入对照组(n=43).分析两组患者溶栓治疗后的梗死面积、心肌酶峰值、并发症情况及病死率.结果 观察组梗死面积、磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)水平分别为(11.47±6.28)分、(1149.64±573.52)U/L、(106.37±64.92)U/L,显著低于对照组[(15.75±9.12)分、(1584.37±747.09)U/L、(152.44±85.76)U/L],P<0.05;观察组的心力衰竭、心源性休克、死亡等发生率分别为31.9%、2.1%、2.1%,显著低于对照组(58.1%、18.6%、16.3%),P<0.05.结论 心肌缺血预适应可以有效减少急性心肌梗死尿激酶溶栓患者心肌酶的释放,缩小心肌坏死面积,对患者的心肌功能具有良好的保护作用.%Objective To study the protective effects of myocardial ischemic preconditioning on myocardial function in patients undergoing urokinase thrombolysis of acute myocardial infarction.Methods Ninety patients undergoing urokinase thrombolysis of acute myocardial infarction from March 2012 and March 2015 were enrolled in the study.The patients with angina within 48 h were divided into observation group (n=47), and patients without angina within 24 h were divided into the control group (n=43).The infarct size, peak value of myocardial enzyme, complications and mortality rates in the two groups were analyzed after urokinase thrombolysis.Results The infarction size, levels of creatine kinase (CK) and creatine kinase isoenzyme (CK-MB) in observation group [(11.47±6.28), (1149.64±573.52)U/L, (106.37±64.92) U/L] were significantly lower than those in control group [(15.75±9.12), (1584.37±747.09) U/L, (152.44±85.76) U/L],P<0.05;The incidences of heart failure, cardiogenic shock and death in the observation group (31.9%, 2.1%, 2.1%) were significantly lower than those in the control group (58.1%, 18.6%, 16.3%),P<0.05.Conclusions Myocardial ischemic preconditioning can effectively reduce the release of myocardial enzymes in patients with acute myocardial infarction after urokinase thrombolysis, and reduce the area of myocardial necrosis.It has good protective effects on the myocardial function of patients.
