论文部分内容阅读
目的近年来,经皮冠状动脉介入术(percutaneous coronary intervention,PCI)广泛应用于临床,如何有效减轻心肌再灌注损伤是一项需要解决的问题。文中旨在观察磷酸肌酸钠(creatine phosphate,CrP)对急性冠状动脉综合征(acute cor-onary syndrome,ACS)患者PCI术后的心肌保护作用。方法 180例ACS患者成功行PCI术后随机分为治疗组90例[男53例、女37例,平均年龄(63.6±12.4)岁]和对照组90例[男56例、女34例,平均年龄(65.3±12.6)岁]。对照组于PCI术前、术后只给予ACS常规药物治疗,治疗组在常规药物治疗基础上于PCI术后静脉应用CrP治疗5 d。监测所有患者术前及术后血清中磷酸肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌钙蛋白T(troporin T,cTnT)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdenyde,MDA)及一氧化氮(nitric oxide,NO)含量变化。结果治疗组术后血清中SOD含量明显高于对照组[41.2(10.3～168.2)pg/ml vs 32.4(10.5～96.8)pg/ml,P<0.01)];而血清MDA、LDH、CK-MB含量均明显低于对照组[3.22(1.00～7.84)pg/ml vs 3.67(0.58～9.82)pg/ml;156.2(84.0～703.5)U/L vs 176.5(94.0～983.7)U/L;11.0(5.0～104.0)U/L vs 14.5(5.0～196.5)U/L,P<0.01)];2组术后血清中cTnT及NO含量变化无明显差异[1.25(0.01～8.5)ng/ml vs 1.37(0.01～9.2)ng/ml;165.5(22.5～437.7)μmol/L vs159.6(20.3～414.4)μmol/L,P>0.05)]。结论 CrP对ACS患者PCI术后心肌具有一定保护作用。
Objective In recent years, percutaneous coronary intervention (percutaneous coronary intervention, PCI) is widely used in clinical practice, how to effectively reduce myocardial reperfusion injury is a problem to be solved. The aim of this study was to investigate the protective effect of creatine phosphate (CrP) on myocardial after PCI in patients with acute cor-onary syndrome (ACS). Methods A total of 180 ACS patients were randomly divided into treatment group (53 males and 37 females, mean age 63.6 ± 12.4 years) and 90 cases (control group, 56 males and 34 females) Age (65.3 ± 12.6) years]. Control group before PCI, after surgery was given only conventional ACS treatment, the treatment group on the basis of conventional drug therapy in the vein after PCI PCI for 5 d. The levels of CK-MB, lactate dehydrogenase (LDH), troponin T (cTnT) and supernatants were detected in all patients before and after operation. Superoxide dismutase (SOD), malondialdensity (MDA) and nitric oxide (NO) contents were measured. Results Serum levels of SOD in the treatment group were significantly higher than those in the control group [41.2 (10.3-168.2) pg / ml vs 32.4 (10.5-96.8 pg / ml, P <0.01) The content was significantly lower than the control group [3.22 (1.00-7.84) pg / ml vs 3.67 (0.58-9.82) pg / ml; 156.2 (84.0-703.5) U / L vs 176.5 (94.0-983.7) U / 5.0 ~ 104.0) U / L vs 14.5 (5.0 ~ 196.5) U / L, P <0.01). There was no significant difference in serum cTnT and NO levels between the two groups (0.01 ~ 9.2) ng / ml; 165.5 (22.5 ~ 437.7) μmol / L vs159.6 (20.3 ~ 414.4) μmol / L, P> 0.05). Conclusion CrP can protect myocardium after PCI in ACS patients.