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急性心肌梗塞症状发作后24小时内,其血浆游离脂肪酸(FFA)升高,急性心肌缺血患者FFA升高往往与严重室性心律不齐发生率之增高有关。烟酸可抑制脂肪细胞内环磷腺苷的积聚,储存脂肪的脂解减低,使进入血浆的FFA及甘油三酯减少。理论上抑制脂解可减少室性心律不齐的发生及改善急性心肌局部缺血时心肌的功能。但烟酸能引起周围血管扩张及增加心输出量,故不适用于急性心肌梗塞患者。本文叙述了烟酸类似物5-氟-3-羟甲基嘧啶(NAA)的应用,它可代谢为5-氟烟酸,延长烟酸抑制FFA释放的作用,从而降低血浆FFA水平。不胖的正常人口服200毫克NAA后,15分钟血
Within 24 hours after onset of symptoms of acute myocardial infarction, plasma FFA increases. Elevated FFA in patients with acute myocardial infarction is often associated with an increased incidence of severe ventricular arrhythmias. Nicotinic acid inhibits the accumulation of cyclic adenosine monophosphate in adipocytes, reduces the lipolysis of stored fat, and decreases FFA and triglycerides into the plasma. Inhibition of lipolytic in theory can reduce the incidence of ventricular arrhythmia and improve myocardial function in acute myocardial ischemia. However, niacin can cause peripheral blood vessels to dilate and increase cardiac output, it is not suitable for patients with acute myocardial infarction. This article describes the use of nicotinic acid analog 5-fluoro-3-hydroxymethylpyrimidine (NAA), which metabolizes 5-fluoronicotinic acid and prolongs the inhibitory effect of nicotinic acid on FFA release, thereby reducing plasma FFA levels. After taking 200 mg NAA orally, 15-min blood is given to the non-fat normal subjects