前列腺素E_1对心肌缺血-再灌注损伤保护作用的观察

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目的:研究心肌缺血再灌注时人体外周血中性粒细胞(PMN)的数量、PMN聚集率、内皮素(ET)、脂质过氧化物(LPO)、超氧化物歧化酶(SOD)及过氧化氢酶(CAT)的变化,并观察前列腺素E1(PGE1)对心肌缺血再灌注损伤的保护作用。方法:将36例急性心肌梗死患者随机分为2组,每组18例。治疗组给予PGE1加尿激酶和硝酸甘油静滴,对照组给予尿激酶和硝酸甘油静滴,于再灌注前后分别采静脉血测定上述指标。结果:心肌缺血时外周血PMN数量无显著增多,但PMN活性显著增强,血ET及LPO水平增高,血SOD和CAT活性下降;再灌注后,PMN数量无明显增多(P均>0.05),但PMN活性进一步显著增强,ET及LPO水平进一步显著增高,而SOD和CAT活性则进一步显著下降。使用PGE1治疗后结果则与上述情况相反。结论:PMN及ET在心肌缺血再灌注损伤过程中起重要作用,PGE1可以抑制PMN活性,保护SOD和CAT活性,减少ET及LPO产生,减轻过氧化反应,对心肌缺血再灌注损伤有显著的保护作用。 Objective: To study the changes of PMN, PMN accumulation, ET, LPO, SOD in myocardial ischemia-reperfusion and Catalase (CAT) changes, and observe the protective effect of prostaglandin E1 (PGE1) on myocardial ischemia-reperfusion injury. Methods: Thirty-six patients with acute myocardial infarction were randomly divided into two groups with 18 cases in each group. The treatment group was given PGE1 plus intravenous infusion of urokinase and nitroglycerin, the control group was given intravenous infusion of urokinase and nitroglycerin, before and after reperfusion venous blood were collected to measure the above indicators. Results: There was no significant increase of PMN in myocardial ischemia, but the activity of PMN was significantly increased, the levels of ET and LPO were increased, while the activities of SOD and CAT were decreased. However, the numbers of PMN were not significantly increased after reperfusion ), PMN activity was further significantly enhanced, ET and LPO levels were significantly increased, while SOD and CAT activity was further significantly decreased. The result after treatment with PGE1 is the opposite of the above. CONCLUSION: PMN and ET play an important role in the process of myocardial ischemia-reperfusion injury. PGE1 can inhibit the activity of PMN, protect the activities of SOD and CAT, reduce the production of ET and LPO, alleviate the peroxidation and have a significant effect on myocardial ischemia-reperfusion injury The protective effect.
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