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目的 为探讨心绞痛对心肌梗塞后心功能的影响。方法 对 1 4 5例急性心肌梗塞 (AMI)患者临床回顾性分析 ,阐明梗塞前心绞痛 (PAP)对心肌梗塞范围、梗塞后并发症及恶性心律失常等方面所起的作用。结果 PAP组有较少坏死Q波数 (P <0 0 1 )和异常室壁运动个数 (P <0 0 5) ,有显著降低的CK和CK MB峰值 (P <0 0 1 ) ,左室和右室射血分数也较高 (P <0 0 5)。住院期间心功能不全发生率明显下降 ,2 4小时内室性早搏、室性心动过速、室颤和房室传导阻滞发生率明显降低 (P <0 0 1 ) ,而左室高峰充盈率 (LVPFR)和侧支循环相比较无明显差异。提示 :PAP具有缩小心肌梗塞范围 ,保护心脏收缩功能 ,抗恶性心律失常的作用。对心脏舒张功能、房颤、梗塞后心绞痛和室壁瘤等可能无保护作用。
Objective To investigate the impact of angina on cardiac function after myocardial infarction. Methods A retrospective analysis of 145 cases of acute myocardial infarction (AMI) patients was performed to elucidate the role of pre-infarction angina pectoris (PAP) in the range of myocardial infarction, post-infarction complications and malignant arrhythmia. Results The number of Q waves (P <0.01) and the number of abnormal wall motion (P <0 05) in the PAP group were significantly lower than those in the PAP group (P <0.01) And right ventricular ejection fraction was also higher (P <0 05). During hospitalization, the incidence of cardiac insufficiency decreased significantly, and the incidence of ventricular premature beats, ventricular tachycardia, ventricular fibrillation and atrioventricular block was significantly decreased within 24 hours (P <0.01), while the left ventricular peak filling rate (LVPFR) and collateral circulation compared with no significant difference. Tip: PAP has narrowed the scope of myocardial infarction, protection of cardiac systolic function, anti-malignant arrhythmia role. Right ventricular diastolic function, atrial fibrillation, post-infarction angina and aneurysm may have no protective effect.