远端缺血预适应对行择期PCI治疗的老年冠心病患者心脏保护作用被引量：7

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摘要目的探讨短暂远端肢体缺血预适应(RIPC)对择期行经皮冠状动脉介入(PCI)治疗的老年冠心病患者心脏保护作用。方法选取择期行PCI治疗的老年冠心病患者108例,随机分为对照组55例和RIPC组53例。术前2 h内对RIPC组患者行缺血预处理(给予患者缺血5 min后再灌注5 min,3个循环,共计30 min),对照组无缺血预处理。分别测定两组入院时及术后即刻血清缺血修饰蛋白(IMA),入院时及术后24 h血清肌钙蛋白I(c Tn I),观察记录术中术后胸痛不适发生率及4a型心肌梗死发生率。结果对照组手术前后血清IMA分别为(77.28±13.99)、(125.74±20.28)pg/m L,术前术后血清IMA差值为(48.46±21.95)pg/m L;手术前后血清c Tn I分别为(0.02±0.03)、(0.25±0.61)ng/m L,术前术后血清c Tn I差值为(0.23±0.60)ng/m L。RIPC组手术前后血清IMA分别为(78.56±12.56)、(111.651±15.78)pg/m L,术前术后血清IMA差值为(33.09±19.23)pg/m L;手术前后血清c Tn I分别为(0.02±0.03)、(0.09±0.17)ng/m L,术前术后c Tn I差值为(0.07±0.18)ng/m L。两组术前IMA、c Tn I比较无统计学差异(P均>0.05);两组术后IMA、c Tn I比较及术前术后血清IMA、c Tn I差值比较有统计学差异(P均<0.05)。对照组与RIPC组术中术后胸痛不适发生率为58%和30%,4a型心肌梗死发生率分别为16%和4%,两组比较均有统计学差异(P均<0.05)。结论择期PCI术前给予患者短暂的RIPC可有效保护心肌,降低4a型心肌梗死率,减轻术中术后胸痛不适。

作者郭云青闫晓艺吉奎苏亮李秀芹邵静波

机构地区潍坊医学院潍坊市人民医院

出处《山东医药》 CAS 2018年第1期60-62,共3页 Shandong Medical Journal

关键词冠状动脉疾病远端缺血预适应经皮冠状动脉介入老年人保护作用

分类号 R541.4 [医药卫生—心血管疾病]

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1Min Zhang,Huiwei He,Ze-Mu Wang,Zhihui Xu,Ningtian Zhou,Zhengxian Tao,Bo Chen,Chunjian Li,Tiebing Zhu,Di Yang,Liansheng Wang,Zhijian Yang.Diagnostic and prognostic value of minor elevated cardiac troponin levels for percutaneous coronary intervention-related myocardial injury:a prospective,single-center and double-blind study[J].The Journal of Biomedical Research,2014,28(2):98-107. 被引量：12
2陈旻,明腾.心肌缺血再灌注损伤机制的研究进展[J].山东医药,2014,54(41):98-100. 被引量：14
3刘梅颜,贾玫.心肌梗死定义修订的解读及思考[J].中华检验医学杂志,2013,36(6):485-488. 被引量：42
4马光,王国良,刘朋,薛永亮,滕伟,惠学志.肢体缺血预处理对择期冠脉支架置入术中患者心脏保护作用的Meta分析[J].中国循证医学杂志,2017,17(1):87-93. 被引量：4
5陈伟伟,高润霖,刘力生,朱曼璐,王文,王拥军,吴兆苏,李惠君,顾东风,杨跃进,郑哲,蒋立新,胡盛寿.《中国心血管病报告2015》概要[J].中国循环杂志,2016,31(6):521-528. 被引量：949

二级参考文献54

1The Joint European Society of Cardiology/American College of Cardiology Committee. Myocardial infarction redefined - A consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. Eur Heart J, 2000, 21:1502-1513.
2Mendis S, Thygesen K, Kuulasmaa K, et al. World Health Organization definition of myocardial infarction :2008-2009 revision. Int J Epidemiol, 2011, 40:139-146.
3White HD. Pathobiology of troponin elevations. J Am Coll Cardiol, 2011,57:2406-2408.
4Apple FS, Jesse RL, Newby LK, et al. National Academy of Clinical Biochemistry and IFCC Committee for Standardization of Markers Cardiac Damage Laboratory Medicine Practice Guidelines : Analytical issues for biochemical markers of acute coronary syndromes. Circulation, 2007, 115 : e352- e355.
5Thygesen K, Mair J, Katus H, et al. Study Group on Biomarkers in Cardiology of the ESC Working Group on Acute Cardiac Care. Recommendations for the use of cardiac troponin measurement in acute cardiac care. Eur Heart J, 2010, 31:2197-2204.
6Thygesen K, Mair K, Giannitsis E, et al. How to use high-sensitivity cardiac troponins in acute cardiac care. Eur Heart J, 2012, 33:2252-2257.
7Apple FS, Collinson PO, IFCC Task Force on Clinical Applications of Cardiac Biomarkers. Analytical characteristics of high-sensitivity cardiac troponin assays. Clin Chem, 2012, 58:54-61.
8Jaffe AS, Apple FS, Morrow DA, et al. Being rational about (im) precision : a statement from the Biochemistry Subcommittee of the Joint European Society of Cardiology/American College of Cardiology Foundation/American Heart Association/World Heart Federation Task Force for the definition of myocardial infarction. Clin Chem, 2010, 56:941-943.
9White HD, Reynolds HR, Carvalho AC, et al. Reinfarction after percutaneous coronary intervention or medical management using the universal definition in patients with total occlusion after myocardial infarction : Results from long- term follow-up of the Occluded Artery Trial (OAT) cohort. Am Heart J, 2012, 163:563-571.
10Rosamond W, Chambless L, Heiss G, et al. Twenty-two year trends in incidence of myocardial infarction, CHD mortality, and case-fatality in four US communities, 1987 to 2008. Circulation, 2012,125:1848-1857.