1,6-二磷酸果糖对急性心肌梗死再灌注治疗的心肌保护作用  

Protective effect of fructose 1,6-diphosphate on early reperfusion therapy in patients with acute myocardial infarction

作　　者：李小宇[1] 张丽琨[1] 杨家声[1] 

机构地区：[1]北京急救中心CCU,100031

出　　处：《北京医学》2004年第5期306-308,共3页Beijing Medical Journal

摘　　要：目的　探讨 1,6 二磷酸果糖 (FDP)对急性心肌梗死 (AMI)者心肌再灌注的心肌保护作用。方法　2 6 4例急性ST段抬高性心肌梗死 (STEMI)患者随机分为FDP组 (135例 )与对照组 (12 9例 ) ,FDP组于再灌注治疗前给予FDP 10g(10 0ml)静脉滴注 ,观察再灌注后早期ST段恢复幅度、T波倒置情况及住院期间重要心脏事件。结果　FDP组较对照组术后 1hST段恢复幅度大 (P <0 .0 5 ) ,T波倒置更早 (P <0 .0 5 ) ;FDP组住院期间主要非致死性心脏事件发生率明显低于对照组 (P <0 .0 5 )。ST段恢复幅度与T波倒置时间与住院期间非致死性心脏事件及死亡率密切相关。结论　FDP应用于STEMI再灌注治疗早期 ,有助于抬高ST段的恢复及T波早期倒置 ,改善近期临床。FDP可能是通过再灌注治疗期的能量调节减轻再灌注损伤 ,改善心肌灌注。Objective Fructose-1,6-diphosphate(FDP),as a cellular substance,has shown its importance in adjuvant treatment of diseases with myocardial damage. We designed a prospective, randomized,placebo-controlled trial in patients undergoing primary angioplasty(PTCA) for acute ST-elevation myocardial infarction (STEMI) with the aim to evaluate the influence of FDP on myocardial reperfusion comparing ST-segment resolution and time of T wave inversion as well as clinical benefits during the in-hospital period.Methods 264 patients with acute ST-elevation myocardial infarction were randomly divided into two groups.Patients in FDP group(n=135) received FDP 10g 20~30 minute’s before reperfusion therapy.All patients underwent continous ST-segment monitoring to assess ST-segment resolution, time point of T wave inversion.Results There was an earlier resolution of ST-segment in 1h after reperfusion therapy,the time of T wave inversion was earlier in the FDP group(P<0.05),and the incidence of nonfatal myocardial complications was significantly lower in the FDP group.Conclusions These results suggest that FDP,being used before reperfusion therapy,can attenuate the ischemia injury.These myocardial protective effects may improve patient’s outcome after reperfusion therapy.

关 键 词：FDP 再灌注治疗 ST段 心脏事件 T波倒置 心肌保护作用 住院期间 恢复 

分 类 号：R542.22[医药卫生—心血管疾病]