Cairns J A
Can Med Assoc J. 1977 Aug 6;117(3):255-62.
The majority of in-hospital deaths from acute myocardial infarction occur as a result of the "power failure" syndrome (severe congestive heart failure and cardiogenic shock), which results from extensive loss of myocardium. The death of myocardial cells is sequential over many hours. Surrounding the central zone of necrosis in an acute myocardial infarction is a zone of ischemic myocardium whose fate might be altered by interventions during the early phase of the infarction. ST-segment mapping, serial measurement of the serum concentration of creatine phosphokinase and myocardial imaging by means of radionuclides are being developed for the noninvasive assessment of infarct size in animals and humans. A number of interventions appear to limit infarct size in animals. There have been relatively few studies in humans to date, but preliminary results suggest that infarct size might be limited by certain interventions. The research has provided important practical benefits in terms of understanding the course of acute myocardial infarction and the potential effects of conventional therapies. For the present, interventions designed to limit infarct size remain in the realm of clinical research; routine clinical use would be inappropriate.
大多数急性心肌梗死的院内死亡是由“心力衰竭”综合征（严重充血性心力衰竭和心源性休克）导致的，而这种综合征是由大量心肌丧失引起的。心肌细胞的死亡在数小时内是循序渐进的。在急性心肌梗死的坏死中心区域周围是缺血心肌带，在梗死早期，其命运可能会因干预措施而改变。目前正在开发ST段标测、肌酸磷酸激酶血清浓度的系列测定以及通过放射性核素进行心肌成像等技术，用于对动物和人类梗死面积进行无创评估。一些干预措施似乎可以限制动物的梗死面积。迄今为止，针对人类的研究相对较少，但初步结果表明，某些干预措施可能会限制梗死面积。这项研究在理解急性心肌梗死的病程以及传统疗法的潜在效果方面提供了重要的实际益处。目前，旨在限制梗死面积的干预措施仍处于临床研究阶段；常规临床应用并不合适。
