首都医科大学学报 ›› 2003, Vol. 24 ›› Issue (1): 51-53.

• 论著·临床研究 • 上一篇    下一篇

缺血预适应的保护作用在老年人减弱

万昕红, 刘晓惠, 杨新春   

  1. 首都医科大学附属北京朝阳医院心内科
  • 收稿日期:2002-01-01 修回日期:1900-01-01 出版日期:2003-01-15 发布日期:2003-01-15

Protection Effect of Ischemic Preconditioning is Less Obvious in Elderly Patients

Wan Xinhong, Liu Xiaohui, Yang Xinchun   

  1. Department of Cardiology, Beijing Chaoyang Hospital, Affiliate of Capital University of Medical Sciences
  • Received:2002-01-01 Revised:1900-01-01 Online:2003-01-15 Published:2003-01-15

摘要: 为了解缺血预适应对老年急性心肌梗死病人预后的影响,将238例因第1次急性心肌梗死住院的病人按年龄分为成年组(≤45岁,n=104例)和老年组(≥65岁,并≤75岁,n=134例)2组,将各组按梗死前是否发生心绞痛再分亚组,分别对各组及各亚组的基线指标、院内治疗、短期预后进行回顾性分析。成年组中梗死前无心绞痛和有心绞痛亚组相比,心源性休克[8(14.8%)∶1(2.0%),P=0.048]、充血性心衰[8(14.8%)∶1(2.0%),P=0.048],梗死后左心功能不全[11(20.4%)∶2(4.0%),P=0.012]均有显着性差异,前者显着高于后者;而老年组2亚组间预后指标无显着性差异。结果提示缺血预适应的保护作用在老年人减弱。

关键词: 缺血预适应, 心肌梗死, 老年人

Abstract: The objectives of the study were to examine whether angina 48 h before acute myocardial infarction provided protection in elderly patients and to retrospectively verify whether preinfarction angina within48 h of the first myocardial infarction exerted a beneficial effet on in hospital outcomes in adults(≤45 years old, n=104)and elderly(≥65 years old and ≤75 years old, n=134)patients. In hospital congestive heart failure (8 vs 1, 14.8 % vs 2.0%, P=0.048), cardiogenic shock(8 vs 1, 14.8 % vs 2.0%, P =0.048) and left ventricular dysfunction (11 vs 2, 20.4% vs 4.0%, P=0.012)were more frequent in adult patients without than in those with previous angina. In contrast, the presence or absence of preinfarction angina did not seem to influence in hospital outcomes in elderly patients. The protective effect from preinfarction angina seemed to be lower in elderly patients than in adults. This study suggests that the absence of preconditioning probably results in the poor in hospital outcomes in elderly patients.

Key words: ischemic preconditioning, myocardial infarction, aged

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