李英　赵丽红

[摘要] 目的 探討间歇性低氧治疗对急性ST段抬高型心肌梗死患者PCI术后的心功能及预后的影响。 方法 选取2016年1月～2017年5月河北省直属机关第二门诊部收治的60例急性ST段抬高型心肌梗死患者，均行PCI术，随机数字表法分为对照组和观察组，每组各30例。术后两组均给予常规西药治疗，观察组在此基础上进行间歇性低氧治疗，对照组进行常氧环境治疗，均持续治疗6个月。比较两组患者治疗后心率、血压、血红蛋白、红细胞变化情况及左室射血分数（LVEF）、左心室收缩末期内径（LVDS）、左室舒张末内径（LVDD）和心脏事件发生情况。 结果 两组心率、血红蛋白和红细胞计数比较，差异无统计学意义（P > 0.05）。治疗1、6个月后观察组收缩压和LVEF高于对照组，LVDS、LVDD低于对照组，差异均有统计学意义（P < 0.05）。 结论 间歇性低氧可促进急性心肌梗死后损伤心肌细胞的修复，改善损伤心肌的收缩能力，促进心肌微循环，抑制梗死后心室重构。

[关键词] 间歇性低氧；急性ST段抬高型心肌梗死；经皮冠状动脉介入治疗；心功能

[中图分类号] R542.2 [文献标识码] A [文章编号] 1673-7210（2018）07（b）-0050-04

Prognosis effect of intermittent hypoxic adaptation in treating patients with ST-segment elevation myocardial infarction after PCI

LI Ying ZHAO Lihong

Integrated TCM & Western Medicine Department， the Second Policlinic Directly under the Authority of Hebei Province， Hebei Province， Shijiazhuang 050000， China

[Abstract] Objective To discuss the effect of intermittent hypoxic adaptation on cardiac function and prognosis of patients with ST-segment elevation myocardial infarction after PCI. Methods All the 60 patients with ST-segment elevation myocardial infarction after PCI were treated in the Second Policlinic Directly under the Authority of Hebei Province from January 2016 to May 2017 selected and divided into control group （n = 30） and observation group （n = 30） by random number table. Based on the standard therapy， the observation group was treated by hypoxia interrupted and the control group was treated by regular oxygen therapy， they were treated for 6 months. The heart rate， blood pressure， Hemoglobin， red blood cell， left ventricular ejection fraction （LVEF）， left ventricular end systolic dimension （LVDS）， left ventricular end diastolic diameter （LVDD） and cardiac events were compared. Results There was no significant difference in heart rate， hemoglobin and RBC count between the two groups （P > 0.05）. At one and six months after treatment， systolic blood pressure and LVEF in the observation group were higher than those in the control group， and LVDS and LVDD was lower than those in the control group， with statistical significance difference （P < 0.05）. Conclusion Intermittent hypoxic adaptation is beneficial to the repair of damaged myocardial cells. Besides， it can improve the ability of myocardium contraction， promote myocardial microcirculation and inhibit ventricular remodeling after myocardial infarction.

[Key words] Intermittent hypoxia； ST-segment elevation myocardial infarction； Percutaneous coronary intervention； Cardiac function

急性心肌梗死（acute myocardial infarction，AMI）是冠状动脉急性、持续性缺血缺氧所引起的心肌坏死，在我国呈明显上升趋势。急性ST段抬高型心肌梗死（STEMI）是指具有典型的缺血性胸痛，持续超过20 min，血清心肌坏死标记物浓度升高并有动态演变，心电图具有典型的ST段抬高的一类AMI[1]。

间歇性低氧（intermittent hypoxia，IH）是机体某种病理和生理状态下的低氧形式，指在一定时间内间断地暴露于低氧环境中，而其余的时间则是处于常氧环境中。有研究显示，间歇性低氧适应与长期高原低氧适应（long-term high-altitude hypoxic adaptation，LHA）和缺血预适应（ischemic preconditioning，IPC）相似，对心脏具有明显的保护作用[2]。具……