摘要
目的探讨肢体远隔缺血适应(RIC)对成功行经皮冠状动脉介入治疗(PCI)的急性ST段抬高型心肌梗死(STEMI)患者冠状动脉微循环灌注及亚硝酸盐(Nitrite)水平的影响。方法选取2016年1月至2017年7月在大连大学附属中山医院行直接PCI的STEMI患者75例,根据随机数字表法按2:1对照原则分为肢体RIC组50例和对照组25例。比较两组患者术后校正的TIMI帧数(CTFC)、术后1 h ST段回落率(STR)的差异,PCI术前及术后血清Nitrite水平的变化,分析肢体RIC组术后Nitrite与CTFC的相关性。结果肢体RIC组CTFC显著低于对照组[(18.12±6.4)帧比(26.04±8.55)帧,P<0.001],而STR≥70%百分率显著高于对照组(88%比64%,P=0.014),差异均有统计学意义;肢体RIC组患者Nitrite水平术后显著大于术前[(16.22±4.96)μmol/L比(10.55±4.37)μmol/L,P<0.001],且术后Nitrite水平显著高于对照组[(16.22±4.96)μmol/L比(13.01±4.16)μmol/L,P=0.007],差异均有统计学意义。Pearson相关性分析显示,肢体RIC组术后血清Nitrite水平与CTFC呈负相关(r=–0.447,P=0.001)。结论肢体RIC能改善成功行PCI的STEMI患者冠状动脉微循环灌注,增加外周血Nitrite水平参与肢体RIC改善冠状动脉微循环的作用。
improve coronary acute ST segment blood. Methods Objective To investigate whether limb remote ischemic conditioning （ RIC ） can microcirculation after percutaneous coronary intervention （PCI） in patients with elevation myocardial infarction （ STEMI ） by increasing nitrite level in peripheral Seventy-five cases of STEMI were selected and according to the order of admission and a 2 ： 1 ratio of randomization, 25 cases were enrolled in the control group and 50 cases in the RIC group. The differences between the two groups in correction TIMI frame count （ CTFC ） , ST segment resolution （ STR ） at 1 hour after PCI, preoperative and postoperative changes in serum levels of nitrite were compared. Results The CTFC of the limb RIC group was lower than that of the control group [ （18.12±6.4） vs. （26.04±8.55） , P〈0.001 ] , and STR ≥70% percentage was also higher than the control group （ 88% vs. 64%, P=0.014 ）. The nitrite level in the limb RIC group increased significantly after operation [ （16.22±4.96） μmol/L vs. （ 10.55 ±4.37） μmol/L, P〈0.001 ] , and was higher than that of the control group [ 16.22±4.96） μmol/L vs. （13.01±4.16） μmol/L, P=0.007 ] . Nitrite level was negatively correlated with CTFC （r=-0.447, P=0.001 ）. Conclusions Limb RIC can improve the coronary microcirculation perfusion in STEMI patients with successful PCI through increasing the level of nitrite in peripheral blood.
作者
曾凯东
谢莲娜
刘灿章
蒋梦
王丽君
魏显敬
解泽宙
王凯君
ZENG Kai-dong;XIE Lian-na;LIU Can-zhang;JIANG Meng;WANG Li-jun;WEI Xian-jing;XIE Ze-zhou;WANG Kai-jun(Department of The Fourth Circulation,Zhongshan Hospital of Dalian University,Dadian 116001,China)
出处
《中国介入心脏病学杂志》
2018年第11期632-637,共6页
Chinese Journal of Interventional Cardiology
关键词
肢体远隔缺血适应
心肌梗死
冠状动脉微循环
Remote ischemic conditioning
Myocardial infarction
Coronary microcirculation
