埃他卡林对低氧性肺动脉高压患者某些血清酶活性及自由基代谢的影响  

Effect of iptkalim on myocardial enzymes and free radicals metabolism with hypoxic pulmonary hypertension

作　　者：崔建华[1] 高亮[1] 张东祥[2] 肖忠海[2] 杨海军[1] 李彬[1] 马广全[1] 汪海[2] 

机构地区：[1]解放军第18医院全军高山病防治研究中心,新疆叶城844900 [2]军事医学科学院卫生学环境医学研究所,天津300050

出　　处：《中国应用生理学杂志》2012年第5期385-388,共4页Chinese Journal of Applied Physiology

基　　金：国家重大新药保密专项(2008ZXJ09004-018/50);高原医学教育部重点实验室资助项目(2011JSGY05);军队"十一五"攻关项目(08G081)

摘　　要：目的:研究埃他卡林对低氧性肺动脉高压(HPH)患者血中心肌酶活性与自由基代谢的影响,为埃他卡林临床治疗HPH的作用机制提供依据。方法:在海拔5 000m以上高原,将110名HPH患者随机分为埃他卡林治疗组(试验组,n=74)和安慰剂对照组(n=36),治疗前、治疗6个月后分别采血检测丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、γ-谷氨酰转肽酶(γ-GT)、肌酸激酶(CK)、乳酸脱氢酶(LDH)、丙二醛(MDA)、一氧化氮(NO)的含量及超氧化物歧化酶(SOD)、一氧化氮合酶(NOS)的活性。结果:服药前试验组较对照组ALT、AST、γ-GT、CK、LDH、MDA、NO、SOD、NOS的活性无统计学差异(P>0.05);服药6个月后试验组较对照组ALT[(56.70±9.87)vs(65.90±10.40)]、AST[(56.30±11.40)vs(66.47±9.73)]、γ-GT[(66.53±8.96)vs(74.97±6.51)]、CK[(200.90±25.38)vs(222.60±30.21)]、LDH[(285.85±25.97)vs(309.92±38.18)]、MDA含量均降低,SOD[(71.09±8.78)vs(64.18±7.28)]、NO[(57.70±12.80)vs(48.10±7.99)]含量增高,NOS[(40.24±6.64)vs(34.40±7.01)]活性增高,MDA[(6.74±1.64)vs(8.67±1.77)]含量降低,差异有统计学意义(P<0.05)。结论:氧自由基参与了HPH的发生发展过程,埃他卡林减轻脂质过氧化反应,并对低氧造成应激损伤的心肌细胞具有明显的保护作用。Objective： To explore the effects of iptkalim on myocardial enzymes and free radicals metabolism with hypoxic pulmonary hypertension（HPH）,in order to provide evidence for the mechanism of iptkalim on clinical treat.Methods： 110 young men stayed at high altitude above 5 000 m were divided into iptkalim group（n=74） and placebo group（n=36）,aminotransferase（ALT）,aspartate aminotransferase（AST）,γ-glutamyltransferase（γ-GT）,creatine kinase（CK）,lactate dehydrogenase（LDH）,superoxide dismutase（SOD）,malonald ehyde（MDA）,nitric oxide（NO） and nitric oxide synthase（NOS） were detected before and after took medicines for 6 mouths.Results： After took medication for 6 mouths,ALT,AST,γ-GT,CK and LDH were reduced,SOD,NO,and NOS were increased,MDA were reduced,there were very significant difference（P〈0.05）.Conclusion： Oxygen free radicals have taken part in the process of HPH,iptkalim have the effect of anti-peroxidation of lipid and protect myocardial cells stress injured by hypoxia which related with mitochondrial membrane and cell membrane’s KATP channel activation.

关 键 词：高原 低氧性肺动脉高压 埃他卡林 心肌酶 自由基代谢 

分 类 号：R821.52[医药卫生—临床医学]