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European Heart J:血压带或可挽救急性心脏病发作患者的生命

来源:生物谷 2013-09-24 23:59

2013年9月25日 讯 /生物谷BIOON/ --近日,来自奥胡斯大学的研究者通过研究发现,当病人发生急性心脏病时,使用血压带可以明显减少患者随后发生的心脏症状以及降低患者的死亡率,相关研究刊登于国际杂志European Heart Journal上。

在两个较远的器官之间,通过间歇性地阻止血液流向四肢从而产生的短时间的机体缺氧可以保护机体的另一个器官,尤其是在个体心脏病发生的时候尤为重要。研究者Hans Erik Botker在文中阐述了,远距离局部缺血的症状可以平均减少心脏病患者心脏组织损伤30%左右,在治疗的病人中,当血压带置于其上臂时,可以使得血压维持在200mmHg上5分钟从而切断血流量,并且随后进行释放,接着让上臂休息5分钟,刚才被截断的血压就会被用上,需要对该步骤重复4次。

文章中,研究者对251名病人进行跟踪调查研究,结果发现,相比对照组来说,使用血压带的心脏病患者,其产生的新的心脏问题可以降低51%,而且总的死亡数降低了,由心脏疾病引发的死亡也降低了61%。

研究者表示,这其中涉及的机理有可能是机体自身内源性保护系统的激活可以诱导个体在心脏病发作时,对组织损伤产生抗性;然而后期还需要进行大量临床试验研究来确定本文的研究结果,不过本文的研究揭示了血压带这种新型的干预措施可以降低心脏病患者的死亡率以及心脏组织的损伤。(生物谷Bioon.com)

Improved long-term clinical outcomes in patients with ST-elevation myocardial infarction undergoing remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention

Astrid D. Sloth1,*, Michael R. Schmidt1, Kim Munk1, Rajesh K. Kharbanda2, Andrew N. Redington3, Morten Schmidt4, Lars Pedersen4, Henrik T. Sørensen4, Hans Erik Bøtker

Aims Remote ischaemic conditioning as an adjunct to primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction increases myocardial salvage. We investigated the effect of remote ischaemic conditioning on long-term clinical outcome. Methods and results From February 2007 to November 2008, 333 patients with a suspected first acute ST-elevation myocardial infarction were randomized to receive primary percutaneous coronary intervention with (n = 166) or without (n = 167) remote ischaemic conditioning (intermittent arm ischaemia through four cycles of 5-min inflation followed by 5-min deflation of a blood-pressure cuff). Patient follow-up extended from the randomization date until an outcome, emigration or January 2012 (median follow-up = 3.8 years). The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE)—a composite of all-cause mortality, myocardial infarction, readmission for heart failure, and ischaemic stroke/transient ischaemic attack. The individual components of the primary endpoint comprised the secondary endpoints. Outcomes were obtained from Danish nationwide medical registries and validated by medical record review and contact to patients' general practitioner. In the per-protocol analysis of 251 patient fulfilling trial criteria, MACCE occurred for 17 (13.5%) patients in the intervention group compared with 32 (25.6%) patients in the control group, yielding a hazard ratio (HR) of 0.49 (95% confidence interval: 0.27–0.89, P = 0.018). The HR for all-cause mortality was 0.32 (95% confidence interval: 0.12–0.88, P = 0.027). Although lower precision, the HRs were also directionally lower for all other secondary endpoints. Conclusion Remote ischaemic conditioning before primary percutaneous coronary intervention seemed to improve long-term clinical outcomes in patients with ST-elevation myocardial infarction.

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