中文摘要：

目的探讨肾移植后早期（〈3个月）急性心肌梗死（AMI）的临床特点与治疗。方法2011年6月至2012年12月单中心122例肾移植受者中，5例（4．1％）于术后3个月内发生AMI，对其诊断、治疗及结果进行回顾性分析。结果5例中，2例在术后1周内发生AMI，1例在术后11d发生，3例均并发左心功能衰竭；另2例分别于术后29d和术后45d发生AMI。5例患者肌钙蛋白I（TnI）均升高明显，随后降低，检测峰值〉5μg／L，其中2例术后1周内发生AMI者TnI〉20μg／L。所有患者经对症支持、抗凝血、抗血栓形成、抗心肌缺血等综合治疗后，病情改善。2例术后1周内发生AMI者加用低分子肝素治疗，3d后B型超声提示移植肾周新出现少量积血，逐停用。5例均未行溶栓或经皮冠状动脉介入治疗，无1例因心肌梗死导致死亡。结论肾移植后AMI病情危重，对于高危患者应注意降低AMI的发生风险。肾移植受者AMI的治疗可以应用抗血小板药物、B受体阻滞剂、血管紧张素转化酶抑制剂或血管紧张素受体阻滞剂以及他汀类药物，而溶栓和介入治疗应慎重。

英文摘要：

Objective To explore the clinical characteristics and management of acute myocardial infarction （AMI） early after kidney transplantation （〈3 months）. Method Five cases of AMI early posttransplantation among 122 kidney transplant recipients from June 2011 to December 2012 were retrospectively reviewed. Results Of 5 AMI patients, there were 2 cases within one week postoperatively, one case at 1 lth day postoperation, and the other two at 29th day and 46th day after operation respectively. Acute left heart failure was complicated in 3 cases within first two weeks. All the AMI patients had elevated TnI levels which declined subsequently. The climax of TnI levels in all the 5 AMI patients were above 5 ng/mL, and more than 20 ng/mL in two AMI patients within one week. Given by symptomatic and supportive treatment, antiplatelet and anticoagulation therapies and eardioprotective medications, all the five AMI patients were improved. Low molecular heparin was additionally administrated to the 2 cases within first week according to the severe conditions. New emerged small volume of hematocele was proved by ultrasound after 3 days and low molecular heparin was ceased. All the 5 patients survived and neither thrombolysis nor pereutaneous coronary intervention therapy was given to therrL Conclusion In addition to general prevention against AMI in kidney recipients with high risk factors, managing anemia and hypertensiorl, and improving graft function and systematic status are also important to decrease the risk of AML Moreover, cardioprotective therapy including antiplatelet therapies, beta-blockers, angiotensin-converting enzyme inhibitors （ACEI）/angiotensin-2 receptor blockers and statins, which are recommended to the general population with AMI, will also profit to the kidney transplant recipients with AMI. However, aggressive intervention therapies might be more prudent to he used in this population.