探讨心肌梗死前心绞痛对急性心肌梗死预后的影响

探讨心肌梗死前心绞痛对急性心肌梗死预后的影响

摘要：目的：探讨并分析心梗前发生心绞痛对急性心肌梗死近期预后的影响。

方法：此次研究的对象是选择心肌梗死患者100例，将其临床资料进行回顾性分析，并根据患者在发生心肌梗死前72h内是否发生心绞痛分为两组，发生心绞痛

者为观察组，未发生心绞痛者为对照组，比较两组患者心功能改变情况和预后之

间存在的差异。结果：1.观察组治疗前的CK（621.4±22.9U/L）、CK-MB

（72.5±10.4U/L）峰值和治疗后的峰值（212±27.4U/L、31.5±6.6U/L）均小于对照组，差异有统计学意义（P<0.05）；两组治疗后LVEF均升高，但观察组升高更加

明显。2.观察组患者发生心律失常（30%）、心力衰竭（15%）等严重影响预后的

疾病的几率明显小于对照组（40%、28%），差异有统计学意义（P<0.05）。4.观

察组中死亡6例，占6.67%，对照组中死亡9例，占18%，观察组患者的死亡率

明显低于对照组。结论：心肌梗死前出现心绞痛者预后比未出现者好，可能因为

心绞痛后缺血预适应而对心肌有良好的保护从而能够改善患者的预后。

关键词：心肌梗死前；心绞痛；预后；影响

Abstract：Objective：To investigate and analyze the effect of angina pectoris before myocardial infarction on short-term prognosis of acute myocardial infarction. Methods：the subjects of this study is to select patients with myocardial infarction in 100 cases，the retrospective analysis of the clinical data，and according to the occurrence of myocardial infarction in patients with 72h is the occurrence of angina were divided

into two groups，the incidence of angina pectoris patients as the observation group，no angina as control group，and the difference between the prognosis of change were compared between the two groups of cardiac function. Results：1. the observation group before treatment CK（621.4 + 22.9U/L），CK-MB（72.5 + 10.4U/L）peak and after treatment（212 + 27.4U/L，31.5 + 6.6U/L）were less than the control group，the difference was statistically significant（P<0.05）；LVEF increased after treatment in the two groups，but the observation group increased more significantly. 2. the incidence of arrhythmia（30%）and heart failure（15%）in the observation group was significantly lower than that in the control group（40%，28%），and the difference was statistically significant（P<0.05）. 4. in the observation group，6 cases died，accounting for 6.67%，9 cases in the control group died，accounting for 18%，the mortality rate of the observation group was significantly lower than that of the control group. Conclusion：the prognosis of patients with angina pectoris before myocardial infarction is better than that of the patients without angina pectoris. It is possible that the ischemic preconditioning can effectively protect the myocardium and improve the prognosis of the patients.

Keywords：myocardial infarction；angina pectoris；prognosis；influence 急性心肌梗死患者发病前出现心绞痛（AP），会对冠脉侧支循环和心梗面积等产生影响，

且关系到患者的近期预后[1]，笔者通过对50例发生心肌梗死前72h内发生心绞痛的患者的

各项指标进行了统计学分析，现将结果汇报如下：

1资料与方法

1.1一般资料

选择我院2014年9月至2016年9月收治的诊断为心肌梗死的患者100例，将60例急性

心梗前72小时内出现心绞痛的患者，归为观察组，50例未出现心绞痛的患者归为对照组。

其中，观察组男38例，女22例，年龄35-76岁，平均年龄61.2±17.6岁；对照组男32例，