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大量实验研究证实,心肌缺血再灌注后,缺血区心肌之血供虽能迅速恢复,但却存在着暂时的舒缩功能障碍,其持续时间从10分钟到数日不等。这种心肌缺血后局部心肌功能的暂时丧失称之为心肌缺血后“迟呆状态”(Stunned myocardium,SM)。近年来,许多学者就此现象作了深入的研究,并渐为临床工作者所重视。本文据现有研究资料就SM的基本特点、发生机制及临床意义作一概述。一、SM的基本特点 1.“迟呆状态”持续时间与心肌缺血时间呈正相关。有人观察了狗冠状动脉结扎5分钟和15分钟后再灌注24小时内缺血区心肌的舒缩功能,发现缺血时间为5分钟的心肌,再灌注后其舒缩功能的恢复仅需3小时,而缺血15分钟再灌注的心肌舒缩功能的恢复则长达10小时或以上。
A large number of experimental studies have shown that myocardial ischemia and reperfusion, myocardial ischemia in the blood supply although the rapid recovery, but there is a temporary systolic and diastolic dysfunction, and its duration from 10 minutes to several days. This temporary loss of regional myocardial function after myocardial ischemia is called “myocardial infarction” (Stunned myocardium, SM). In recent years, many scholars made in-depth research on this phenomenon, and gradually attach importance to clinicians. This article based on existing research data on the basic characteristics of SM, the mechanism and clinical significance of an overview. First, the basic characteristics of SM 1. “Delayed state” duration and myocardial ischemia was positively correlated. It was observed dog coronary artery ligation 5 minutes and 15 minutes after reperfusion within 24 hours of myocardial ischemia and contraction function and found that the ischemic time of 5 minutes of myocardium after reperfusion systolic and functional recovery only 3 hours , Whereas the recovery of myocardial systolic and diastolic function after 15 minutes of ischemia reperfusion was as long as 10 hours or more.