急性心肌梗死患者氧化应激水平与院前延误时间及早期预后的相关性研究  

Associations of Oxidative Stress Levels with Prehostipal Delay Time and Early Prognosis in Patients with Acute Myocardial Infarctions

作　　者：谭文鹏[1] 杨侃[1] 孙明[2] 

机构地区：[1]中南大学湘雅三医院心内科,湖南省长沙市410013 [2]中南大学湘雅医院心内科

出　　处：《中国全科医学》2011年第32期3684-3686,共3页Chinese General Practice

摘　　要：目的探讨急性心肌梗死患者血清8-羟基脱氧鸟苷(8-OHdG)与胸痛起病到就诊时间即院前延误时间(PDT)及早期预后的关系。方法 69例行急诊经皮冠状动脉介入治疗(PCI)的急性ST段抬高性心肌梗死患者,按PDT分为≤6 h组和>6 h组。检测入院时及PCI术后24 h血清8-OHdG、肌酸激酶同工酶(CK-MB)水平,2周后,行超声心动图检查,检测左室射血分数(LVEF)。另设胸痛患者20例为对照组,行冠状动脉造影排除冠心病,检测入院时及冠状动脉造影术后血清8-OHdG水平。结果心肌梗死患者入院时及PCI术后24 h血清8-OHdG水平均显著高于对照组(P<0.01),PCI术后24 h血清8-OHdG、CK-MB水平较入院时明显升高(P<0.05);与PDT≤6 h组比较,PDT>6 h组血清8-OHdG、CK-MB水平显著升高(P<0.01),LVEF明显降低(P<0.05);PDT≤6 h组及PDT>6 h组8-OHdG水平与LVEF呈负相关(r值分别为-0.543和-0.594,P<0.01)。结论急性心肌梗死患者的血清8-OHdG水平与PDT相关,并在评估心功能方面有重要临床意义。Objective To observe the association between the level of serum 8-hydroxy-2′-deoxyguanosine（8-OHdG） and prehospital delay time（PDT） as well as prognosis in patients with acute ST-elevation myocardial infarction（ASTEMI）.Methods A total of 69 patients underwent percutaneous coronary intervention（PCI） for ASTEMI were divided into two groups according PDT：≤6 h group and6 h group,with another 20 patients of non-coronary artery disease confirmed by coronary angiography（CA） served as the control group.Serum levels of 8-OHdG and CK-MB were measured at hospitalization and 24 h after PCI with cardiac function and LVEF examined 2 weeks later.Results Serum 8-OHdG levels in the ASTEMI groups were significantly higher than in the control group at hospitalization and 24 h after PCI（P0.01）.Serum 8-OHdG and CK-MB levels increased significantly 24 h after PCI compared with at hospitalixation（P0.05）.Compared with the ≤6 h group,8-OHdG and CK-MB levels in the 6 h group increased significantly（P0.01） while cardiac function in the 6 h group decreased significantly（P0.05）.Serum 8-OHdG levels were negatively correlated with cardiac function in both the ≤6 h group and the 6 h group（r=-0.543,-0.594）（P0.01）.Conclusion Serum 8-OHdG is correlated with prehospital delay time and has important clinical values in assessing heart failure in patients with ASTEMI.

关 键 词：氧化性应激 脱氧鸟苷 心肌梗死 血管成形术 经皮冠状动脉 

分 类 号：R542.22[医药卫生—心血管疾病]