乌司他丁对急性心肌梗死行急诊冠状动脉介入治疗后再灌注性心律失常的保护作用  

Protective Role of Ulinastatin on Reperfusion Injury Caused Arrhythmia in Patients of Acute Myocardial Infarction With Emergent Percutaneous Coronary Intervention Treatment

作　　者：李琛[1] 梁健球[1] 许建强[1] 吴庆庆[1] 吴剑弟[1] 赖绍斌 夏张青[1] 周少雄[1] 

机构地区：[1]佛山市第二人民医院心内科,广东省528000

出　　处：《中国循环杂志》2013年第4期258-261,共4页Chinese Circulation Journal

基　　金：广东省心血管用药研究基金(项目编号:2011X32);中国医师协会阳光心血管研究基金(课题编号:SCRFCMDA201234)

摘　　要：目的:观察乌司他丁对急性心肌梗死(AMI)行急诊经皮冠状动脉介入治疗(PCI)后再灌注性心律失常的影响,探讨乌司他丁与白介素-6、白介素-10、超氧化物歧化酶、QT间期离散度、校正后的QT间期离散度(QTcd)及缺血再灌注性心律失常的关系。方法:选择AMI患者100例,随机分为常规PCI组(n=50)与乌司他丁+PCI组(n=50),常规PCI组采用常规治疗方法,乌司他丁+PCI组在常规治疗方法的基础上加用乌司他丁治疗,比较两组患者的血清炎症因子白介素-6、白介素-10、超氧化物歧化酶的水平及QT间期离散度、QTcd和心律失常的发生率。结果:乌司他丁+PCI组患者术后白介素-6水平及QT间期离散度、QTcd和心律失常的发生率明显低于常规PCI组,乌司他丁+PCI组患者术后白介素-10、超氧化物歧化酶水平明显高于常规PCI组,差异均有统计学意义(P<0.05)。结论:与常规PCI组相比,乌司他丁+PCI组恶性心律失常的发生率较低,这可能与乌司他丁+PCI组患者的白介素-6水平、QT间期离散度及QTcd较低,白介素-10、超氧化物歧化酶水平较高有关。Objective： To observe the protective role of ulinastatin on reperfusion injury caused arrhythmia in patients of acute myocardial infarction （AMI） with emergent percutaneous coronary intervention （PCI） treatment, and to explore the relationship between ulinastatin and the levels of interleukin-6 （IL-6）, IL-10, superoxide dismutase （SOD）, QT dispersion （QTd） and corrected QT dispersion （QTcd）. Methods： A total of 100 relevant patients were randomly divided into 2 groups, Routine PCI group, and PCI ＋ ulinastatin group, in which the patients received additional ulinastatin injection, n=50 in each group. The levels of IL-6, IL-10, SOD, QTd, QTcd and the occurrence rate of arrhythmia, cardiac event and sudden death were compared between 2 groups. Results： Compared with Routine PCI group, PCI ＋ ulinastatin group showed lower levels of IL-6, QTd and QTcd, decreased occurrence rate of arrhythmia and sudden death; while higher levels of IL-10 and SOD, P〈O.05 respectively. Conclusion： Ulinastatin may decrease the levels of IL-6, QTd and QTcd; increase the levels of IL-10 and SOD in AMI patients with PCI treatment, and therefore reducing the incidence of aversive arrhythmia and in-hospital cardiac event.

关 键 词：乌司他丁 急性心肌梗死 经皮冠状动脉介入治疗 缺血-再灌注损伤 心律失常 

分 类 号：R54[医药卫生—心血管疾病]