摘要
目的分析前列地尔对急性ST段抬高型心肌梗死(STEMI)PCI术后心肌缺血再灌注损伤的保护效果及作用机制。方法回顾性分析2016年1月-2017年2月兰州军区总医院心血管内科治疗急性ST段抬高型心肌梗死患者116例临床资料,采用前列地尔+常规治疗59例作为观察组,常规治疗57例作为对照组,比较2组患者治疗前后的心电图ST段回落情况,左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD),检测血清肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和肌钙蛋白(cTNI)等心肌酶的浓度变化以及超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)及白细胞介素-1(IL-1)等炎性因子的浓度变化。结果观察组术后4 h、12 h、24 h心电图ST段恢复幅度明显高于对照组(t/P=12.832/0.025、31.674/0.013、53.392/0.008),术后14 d观察组LVEF、LVEDD、LVESD与对照组比较差异有统计学意义(t/P=7.536/0.041、6.958/0.043、6.483/0.046);术后24 h观察组CK-MB、LDH、和cTnI浓度低于对照组(t/P=8.693/0.032、7.325/0.041、7.358/0.042);观察组PCI术后hs-CRP、IL-6、TNF-α及IL-1浓度低于对照组(t/P=7.635/0.035、6.328/0.031、5.693/0.046、5.398/0.046)。结论前列地尔可以通过抑制急性ST段抬高型心肌梗死PCI术后体内炎性因子浓度,从而保护心肌缺血再灌注损伤后的心肌细胞,恢复其心脏功能,值得推广应用。
Objective To analyze the protective effect and mechanism of alprostadil on myocardial ischemia-reperfusion injury in patients with acute ST-segment elevation myocardial infarction(STEMI)after PCI.Methods The clinical data of 116 patients with acute STEMI from January 2016 to February 2017 in the Department of Cardiovascular Medicine of Lanzhou Military Region General Hospital were retrospectively analyzed.Alprostadil plus routine therapy was used as the observation group and routine treatment as the control group.ST-segment depression,left ventricular ejection fraction(LVEF)and left ventricular end-diastolic diameter(LVEDD)were compared between the two groups before and after treatment.Left ventricular end systolic diameter(LVESD),serum creatine kinase isoenzymes(CK-MB),lactate dehydrogenase(LDH),troponin(cTNI)and other myocardial enzymes,as well as hypersensitive C-reactive protein(hs-CRP),interleukin-6(IL-6),tumor necrosis factor(TNF-alpha)and interleukin-1(IL-1)levels were measured.Results The recovery of ST segment of ECG at 4 h,12 h,and 24 h after operation was significantly higher than that of the control group(t/P=12.832/0.025,t/P=31.674/0.013,t/P=53.392/0.008).There were significant differences in LVEF,LVEDD,and LVESD between the 14 th day and the control group(t/P=7.536/0.041,t/P=6.958/0.043,t/P=6.483/0.046);CK-MB,LDH,and The concentration of cTnI was lower than that of the control group at 24 h after operation(t/P=8.693/0.032,t/P=7.325/0.041,t/P=7.358/0.042);after PCI,hs-CRP,IL-6 and TNF-αThe IL-1 concentration observation group was lower than the control group(t/P=7.635/0.035,t/P=6.328/0.031,t/P=5.693/0.046,t/P=5.398/0.046).Conclusion Alprostadil can protect myocardial cells after myocardial ischemia-reperfusion injury and restore their cardiac function by inhibiting the concentration of inflammatory factors after PCI in patients with acute ST-segment elevation myocardial infarction.
作者
韩娟萍
张卫泽
林丽霞
苏芳菊
HAN Juanping;ZHANG Weize;LIN Lixia;SU Fangjuan(Department of Cardiology,Lanzhou Military Region General Hospital,Lanzhou730050,China)
出处
《疑难病杂志》
CAS
2019年第7期657-660,共4页
Chinese Journal of Difficult and Complicated Cases
关键词
前列地尔
冠状动脉介入术
心肌梗死
急性
心肌缺血再灌注损伤
Alprostadil
Percutaneous coronary intervention(PCI)
Acute myocardial infarction(AMI)
Myocardial ischemia reperfusion injury
