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¡¶ÐÄÔàÔÓÖ¾¡·[ISSN:1009-7236/CN:61-1268/R]

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2005ÄêµÚ1ÆÚ

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64-66

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2005-01-05

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Title:

The effect of acute myocardial infarction with or without preinfarction angina on the myocardial damage level

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Author(s):

FAN Changª²qing¹;  LI Jingª²wen²;  PEI Zhaoª²hui³;  TIAN Ye⁴;  YANG Wei⁴;  FU Shiª²ying⁴

1. Department of Cardiology, 174 Hospital of P.L.A., Xiamen, Fujian 360001,China; 2. Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University£¬Harbin,Heilongjiang 150001£¬China; 3. Department of Cardiology, 107 Hospital of P.L.A.,

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ÐĽÊÍ´; ¹£ËÀÇ°; Ðļ¡È±ÑªÔ¤ÊÊÓ¦; Cª²·´Ó¦µ°°×ÖÊ; Ñª¹Ü½ôÕÅËØ¢ò

Keywords:

preinfarction angina; myocardial ischemic preconditioning; cª²reactive protein;  angiotensin¢ò

·ÖÀàºÅ:

R542.22; R5414

DOI:

-

ÎÄÏ×±êʶÂë:

A

ÕªÒª:

Ä¿µÄ ̽ÌÖÐļ¡È±ÑªÔ¤ÊÊÓ¦ºÍÑ×Ö¢ÔÚ¼±ÐÔÐļ¡¹£ËÀ(AMI)ÖеĹØϵ¡£·½·¨ ¸ù¾ÝAMI·¢×÷Ç°24 hÄÚÓÐÎÞÐĽÊÍ´·ÖΪʵÑé×éºÍ¶ÔÕÕ×飬ʹÓÃÃÀ¹úBeckman¹«Ë¾Éú²úµÄIMMAGEÌØÖÖÀàÐ͵°°×·ÖÎöÒÇ£¬²â¶¨ÑªÇåCª²·´Ó¦µ°°×£¨CRP£©Å¨¶È£»·ÅÃâ·¨²â¶¨ÆäѪ¹Ü½ôÕÅËØ¢ò£¨Ang¢ò£©º¬Á¿£»¹Ú×´¶¯ÂöÔìÓ°ÅжÏѪ¹ÜÔÙͨµÄÇ°ÏòѪÁ÷¡£½á¹û ²»Í¬µÄʱ¼äµãCRPŨ¶ÈÔÚÁ½×é¼äÎÞÏÔÖø²îÒ죻²»Í¬Ê±¼äµãµÄAng¢òˮƽÔÚÁ½×éÖ®¼ä¾ù´æÔÚÏÔÖøÐÔ²îÒ죬Óй£ËÀÇ°ÐĽÊÍ´×éÏÔÖøµÍÓÚ¶ÔÕÕ×飻²»Í¬µÄʱ¼äµã²âµÃµÄLVEFÁ½×éÖ®¼äÒà·Ö±ð´æÔÚÏÔÖøÐÔ²îÒ죬Óй£ËÀÇ°ÐĽÊÍ´×éÏÔÖø¸ßÓÚ¶ÔÕÕ×顣סԺÆڼ䲡ËÀÂʺÍÐÄÁ¦Ë¥½ß·¢ÉúÂÊÓй£ËÀÇ°ÐĽÊÍ´×éÏÔÖøµÍÓÚ¶ÔÕÕ×é¡£½áÂÛ ¹£ËÀÇ°ÐĽÊÍ´¶ÔAMIÓÐÀàËÆÐļ¡È±ÑªÔ¤ÊÊÓ¦µÄ±£»¤×÷Ó㻵ÍˮƽAng¢ò¿ÉÄÜÔÚÐļ¡È±ÑªÔ¤ÊÊÓ¦µÄÐļ¡±£»¤ÖÐÆðÖØÒª×÷Óá£Ñ×Ö¢ºÍÐļ¡È±ÑªÔ¤ÊÊÓ¦ÔÚAMIÖÐδ·¢ÏÖ¹ØÁª¡£

Abstract:

AIM To investigate the relation between myocardium ischemic preconditioning and inflammatory process in acute myocardial infarction(AMI) patients. METHODS Preinfarction angina group and control group were classified according to AMI patients with or without preinfarction angina. PTCA+stent performance was used to open infarct related coronary artery to TIMI 3 grades blood flow. Serum cª²reactive protein(CRP) in AMI patients was measured on an automated biochemistry analyzer£¨Beckman. Com.US£©. Angiotensin ¢ò was detected by the radioª²immunity assay. RESULTS ¢ÙThere was no significant difference in serum CRP concentration of each collected sample between the preinfarction angina group and the control group(P>0.05). ¢ÚThere was a significant difference in angiotensin ¢ò concentration of each collected comparedª²sample between preinfarction angina group and the control group(P<0.01). Angiotensin ¢ò concentration of the preinfarction angina group was much lower than that of the control group. ¢ÛThere was a significant difference in left ventricular ejection fraction£¨LVEF£© of each collected comparedª²sample between the two groups (P<0.01). The value of LVEF was much higher in the preinfarction angina group than in the control group. CONCLUSION The protective effect of preinfarction angina is similar to myocardial ischemic preconditioning in AMI patients. Lower serum level of angiotension ¢ò in AMI patients with preinfarction angina may play an important role in myocardial protection in ischemic preconditioning. No significant relation is suggested between inflammatory process and myocardial ischemic preconditioning.

²Î¿¼ÎÄÏ×/References

£Û1£Ý TIMI Study Group. The Thrombolysis in myocardial Infarction (TIMI) trial. Phase I findings£ÛJ£Ý. N Engl J Med,1985,312(14):932-936.

£Û2£Ý Murry CE, Jennings RB, Reimer KA. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium£ÛJ£Ý. Circulation, 1986, 74: 1124-1136.

£Û3£Ý Anzai T, Yoshikawa T, Asakura Y£¬ et al. Preinfarction angina as a major predictor of left ventricular function and longª²term prognosis after a first Q wave myocardial infarction£ÛJ£Ý. J Am Coll Cardiol,1995,26(2): 319-327.

£Û4£Ý Dana A, Sumeray MS, Yellon DM. Ischaemic preconditioning: a clinical perspective£ÛJ£Ý. Hosp Med,1998,59: 216-220.

£Û5£Ý Õź½Ïò,¹¨ÎÀÇÙ,ÌÕÁè. Ðļ¡È±ÑªÔ¤ÊÊÓ¦¶Ôµ¥Ö§¶¯Âö±ÕÈûÐÔ¼±ÐÔÐļ¡¹£ËÀ»¼ÕßµÄÓ°Ïì£ÛJ£Ý.ÐÄÔàÔÓÖ¾,2000,12(4):273-275.

£Û6£Ý Yellon DM, Baxter GF. A ¡°second window of protection¡± or delayed protection preconditioning phenomenon: future horizons for myocardial protection£ÛJ£Ý. J Mol Cell Cardiol, 1995,27(4): 1023-1034.

£Û7£Ý Reimer KA, Jennings RB. Is stunned myocardium a protective mechanism?£ÛA£Ý. Kloner RA, Przyª²klenk K. Stunned Myocardium: Properties, Mechanisms and Clinical Manifestations£ÛM£Ý. New York, Marcel Dekker,1993. 135-152.

£Û8£ÝSteenbergen C£¬Perlman ME£¬London RE£¬ et al. Mechanism of preconditioning£ºionic alterations£ÛJ£Ý. Circ Res£¬1993£¬72(1)£º112-125.

£Û9£Ý de Albuquerque CP£¬Gerstenblith G£¬Weiss RG. Importance of metabolic inhibition and cellular pH in mediating preconditioning contractile and metabolic effects in rat hearts£ÛJ£Ý. Circ Res,1994,74(1):139-150.

±¸×¢/Memo

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¸üÐÂÈÕÆÚ/Last Update: 2010-01-05