心肌缺血再灌注损伤不同表现形式的临床研究

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Abstract Objective To explore the risk factors and prognosis of different manifestations of myocardial ischemia-reperfusion injury. Methods Ninety-one patients who underwent direct percutaneous coronary intervention in Affiliated Hospital of Chengde Medical College from January to November 2015 were divided into groups according to different clinical manifestations of ischemia-reperfusion injury. Twenty-one cases in bradyarrhythmia group and 70 cases in control group 1; 9 cases in tachyarrhythmia group and 82 cases in control group 2; 28 cases in reperfusion hypotension group and 63 cases in control group 3. Medical history, diagnosis, operation and treatment plan, follow-up and summary were recorded. Results The incidence of right coronary artery and collateral circulation of criminals in bradyarrhythmia group was higher than that in control group 1, the incidence of left anterior descending coronary artery of criminals in bradyarrhythmia group was lower than that in control group 1, the differences were statistical significance (P < 0.05). The symptoms-visiting time of tachyarrhythmia group was earlier than that of control group 2, and the incidence of right coronary artery was higher in criminals than that of control group 2, the differences were statistical significance(P < 0.05). The incidence of anterior descending branch of left coronary artery, ejection fraction, 24 h β receptor blocker and 24 h ACEI/ARB of criminals in reperfusion hypotension group were lower than those in control group 3, while the incidence of right coronary artery and total cholesterol level of criminals in reperfusion hypotension group were higher than those in control group 3, the differences were statistical significance (P < 0.05). The survival curves were drawn according to the follow-up results. The Kaplan-Meier survival curves of patients with different clinical manifestations were obtained by Log Rank test, there was no significant difference (P > 0.05). Conclusion The criminals′ right coronary artery is a risk factor for ischemia-reperfusion injury. The presence of collateral circulation is of great significance in predicting bradyarrhythmia, short symptom-visit time, rapid arrhythmia and high total cholesterol level.

Key words： Percutaneous coronary intervention Ischemia reperfusion injure Bradyarrhythmia Tachyarrhythmia Reperfusion hypotension

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	ZHANG Ying WANG Yazhu ZHANG Haoran LIU Chao ZHANG Aiwen SUN WANG Lexian DING Zhenjiang

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ZHANG Ying WANG Yazhu ZHANG Haoran LIU Chao ZHANG Aiwen SUN WANG Lexian DING Zhenjiang. Clinical study on different manifestations of myocardial ischemia-reperfusion injury[J]. 中国医药导报, 2019, 16(23): 64-68.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2019/V16/I23/64

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