缺血后适应对STEMI患者心肌微循环保护的临床研究

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[Abstract]Objective：To explore clinical effect of postconditioning （PC） in the protection of myocardial microcirculation in patients with ST-segment elevation myocardial infarction （STEMI）.Method： A total of 90 patients diagnosedSTEMI in from January 2O23 to March 2O24 were selectedand divided into observation group （n=45）and control group （n=45）by random number table method.The observation group used PC technology toopen infarct-relatedartery （IRA），while thecontrol group used conventional surgical strategy to open IRA.The incidence of IRA non-reflow and compliancerate of thrombolysis in myocardial infarction （TIMI） grade3，inflammatoryfactorsandoxidative stressindexes before treatmentand7daysafter treatment，theincidence of perioperative complications and the occurrnce of major adverse cardiovascular and cerebrovascular events （MACCE） within 6 months after discharge were compared between the two groups.Result： The incidence of IRA non-reflow and compliance rate of TIMI grade 3 in the observation group were 8.89% and 91.11% ，respectively， which were statistically different from 24.44% and 75.56% in the control group （ P <0.05）. Seven days after treatment，thelevelsofCRP，TNF- ∝ and IL- ⋅1β were decreased in both groups compared with those before treatment，and the degree of decrease in the observation group were more significant than those in the control group （P<0.05） .Seven days after treatment，the levels of malondialdehyde （MDA）weredecreased，the levels ofsuperoxide dismutase （SOD） were increased inboth groups compared with those before treatment，and the improvementdegre inthe observation group were more significant than those in the control group （ P<0.05 .The incidence of perioperative complications in the observation group was 4.44% ，whichwasnot different from 6.67% in the control group P>0.05 ）.Theincidence of MACCE in the observation group was 8.89% ，which was not different from 13.33% in the control group （ P >0.05）. Conclusion： PC can efectively reduce the incidence of IRA non-reflow，improve myocardial microcirculation，and alleviate inflammatory and oxidative stress response in STEMI patients.

[Keywords]PostconditioningST-segment elevation myocardial infarctionMyocardial microcirculation

First-author'saddress：Department of Cardiovascular Medicine，， 538000， China

doi：10.3969/j.issn.1674-4985.2025.23.010

ST段拾高型心肌梗死（STEMI）是冠心病中最为严重的临床表现之一，具有极高的发病率和病死率l。（剩余5952字）