摘要
目的:观察重组人组织型纤溶酶原激活剂(rPA)联合还原型谷胱甘肽(GSH)治疗急性ST段抬高型心肌梗死(STEMI)的疗效及安全性。方法:80例急性STEMI患者被随机均分为常规溶栓组和GSH组(溶栓+GSH治疗)。分别于治疗前、治疗后24h检测两组患者血浆cTnT、CK-MB以及超氧化物歧化酶(SOD)活力;1个月后随访不良心血管事件(MACE)发生率,测定LVEDd、LVESd和LVEF。结果:(1)治疗后两组CK-MB,cT-nT、SOD水平均显著升高(P均<0.01),但与常规溶栓组比较,GSH组血浆CK-MB,cTnT水平较低,SOD水平更高(P均<0.05);(2)与常规溶栓组比较,GSH组LVEDd[(55.01±3.56)mm比(51.58±2.97)mm]、LVESd[(47.34±4.83)mm比(42.95±4.58)mm]明显减小,LVEF明显增大[(54.76±4.73)%比(61.21±6.38)%],P均<0.05;3、GSH组较常规溶栓组梗死后心绞痛发生率(22.5%比35.0%)、再发心肌梗死率(5.0%比22.5%)、严重心律失常(17.5%比37.5%)发生率显著下降(P均<0.05)。结论:rPA溶栓联合GSH治疗急性STEMI,能减少冠状动脉再通后并发症,改善心室重构,GSH对缺血再灌注损伤心肌有良好的保护作用。
Objective：To observe therapeutic effects and safety of recombinant human tissue type plasminogen activator（rPA） combined with reduced glutathione hormone（GSH） on patients with acute ST elevation myocardial infarction（STEMI）.Methods：A total of 80 acute STEMI cases were randomly and equally divided into routine thrombolysis group and GSH group（received GSH based on routine thrombolysis）.Plasma levels of cTnT,CK-MB and activity of superoxide dismutase（SOD） were measured before and 24h after treatment.On one month after treatment,LVEDd,LVESd and LVEF were measured;incidence rates of adverse cardiovascular events（MACE）were detected.Results：（1） Compared with before treatment,plasma levels of CK-MB,cTnT and SOD significantly increased after treatment in both groups（P〈0.01 all）,but compared with routine thrombolysis group the levels of CK-MB,cTnT were less,and SOD was more in GSH group（P〈0.05 all）;（2）Compared with routine thrombolysis group,there were significantly decreased in LVEDd [（55.01±3.56） mm vs.（51.58±2.97） mm],LVESd [（47.34±4.83） mm vs.（42.95±4.58） mm],and significantly increased in LVEF [（54.76±4.73）% vs.（61.21±6.38）%]in GSH group,P〈0.05 all;3.Compared with routine thrombolysis group,there were significantly decreased in incidence rate of angina pectoris after myocardial infarction（35.0% vs.22.5%）,recurrence rate of myocardial infarction（22.5% vs.5.0%） and incidence rate of severe arrhythmias（37.5% vs.17.5%） in GSH group,P〈0.05 all.Conclusion：rPA combined with GSH can significantly decrease MACE after coronary artery recanalization in patients with acute STEMI.GSH can exert protective effects on impaired myocardium after ischemia-reperfusion.
出处
《心血管康复医学杂志》
CAS
2012年第1期61-64,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心肌梗塞
心肌再灌注损伤
谷胱甘肽
Myocardial infarction
Myocardial reperfusion injury
Glutathione
