摘要
目的:分析急性心肌缺血再灌注损伤中依达拉奉缺血后处理的作用及其机制。方法:选取2014年01月~2017年01月本院收治的100例住院急性心肌梗死患者,随机分为对照组(A组)和依达拉奉后处理组(B组),每组各50例,A组患者采用普通经皮冠状动脉介入治疗(Percutaneous coronary intervention,PCI),B组患者采用依达拉奉(30 mg加0.9%氯化钠注射液100mL中心静脉滴注,持续至PCI术后1h)后处理。PCI术后1h对比再灌注心律失常、梗死后心绞痛以及ST段再抬高发生状况,选取冠脉CT对血管再通情况予以测定,同时记录4周病死率。采用双抗体夹心酶联免疫吸附法对肿瘤坏死因子(Tumor nerosis factorα,TNF-α)、肿瘤坏死因子(Tumor nerosis factorα,TNF-α)以及血清白细胞介素1β(Interleukin-1β,IL-1β)予以检测,同时对超氧化物歧化酶(Superoxide dismutase,SOD)活性与血清丙二醛(Malondialdehyde,MDA)含量予以测定。结果:(1)与B组比较,A组患者的ST段再抬高、梗死后心绞痛以及再灌注心律失常发生率更高,差异有统计学意义(P<0.05)。(2)A组冠状动脉再通率94%略低于B组的98%,但是两者差异没有统计学意义(P>0.05),4周病死率B组16%明显低于A组的26%,差异有统计学意义(P<0.05)。(3)与A组相比,B组血清TNF-α、IL-1β、IL-6含量均明显降低(P<0.05)。(4)与A组相比,B组血清中MDA含量降低,而血清SOD活性则明显升高(P<0.05)。结论:依达拉奉药物后处理可降低心肌缺血再灌注损伤,能有效清除氧自由基、提高机体抗氧化应激能力,最终降低急性心肌梗死后再灌注心律失常、梗死后心绞痛发生率及病死率。
Objective：To explore the protective effect and mechanism of edaravone postconditioning injection on acute myocardial ischemia reperfusion injury.Methods：One hundred patients with acute myocardial infarction in our hospital from June 2011 to June2016 were selected and randomly divided into the observation group（B group）for 50 cases and the control group（A group）for 50 cases according to the random number table method.Patients in A Group were treated with ordinary percutaneous coronary interention（PCI）,and patients in B group were treated with edaravone postconditioning injection（30 mg＋0.9% NaCl 100 ml）.Raising of ST segment,arrhythmia,and fatality rate of 4 weeks at 1 hour post-operation were observed.The serum content of TNF-α,IL-1β,IL-6,methane dicarboxylic aldehyde（MDA）and activity of superoxide dismutase（SOD）were tested by bi-antibody sandwich enzyme-linked immune-sorbent assay.Results：（1）Compared with group A,raising of ST segment,arrhythmia,and fatality rate of 4 weeks significantly decreased in Group B（P〈0.05）.（2）The recanalization rate of B group was 98%,there was no significant difference group A（94%）and B,the mortality for 4 weeks of B group was 16%,it was significantly lower than the 26% of A group,the differences were statistically significant（P〈0.05）.（3）Compared with group A,levels of serum TNF-a,IL-1β,IL-6 significantly decreased in group B（P〈0.05）.（4）Compared with group A,the level of serum MDA significantly decreased in group B（P〈0.05）,and the activity of SOD significantly increased in group B（P〈0.05）.Conclusion：In acute myocardial ischemia,after edaravone treatment before reperfusion can alleviate myocardial ischemia reperfusion injury,effectively clear oxygen free radical,improve the ability of antioxidative stress.Edaravone can reduce the rate of arrhythmia,stenocardia and fatality in 4 weeks after ischemia reperfusion.
作者
周珏珉
Zhou Jue-min(Department of Electrocardiogram, Suining Central Hospital, Sichuan Suining 62900)
出处
《四川生理科学杂志》
2017年第4期197-199,共3页
Sichuan Journal of Physiological Sciences
关键词
缺血/再灌注损伤
自由基
缺血后处理
依达拉奉
Isehemia/reperfusioninjury
Free radical
Ischemie postconclitioning
Edaravone
