别嘌醇改善急性心肌梗死患者心肌再灌注损伤的临床研究  

Allopurinol ameliorates myocardial reperfusion injury in patients with acute myocardial infarction

作　　者：李均[1] 张颖[1] 岳瑞华[1] 沈钧乐[1] 肖骏[1] 

机构地区：[1]重庆市急救医疗中心心内科,400014

出　　处：《重庆医学》2015年第20期2765-2767,共3页Chongqing medicine

基　　金：重庆市卫生计生委医学科研计划项目(20142083)

摘　　要：目的探讨别嘌醇预处理对急性心肌梗死(AMI)患者行急诊经皮冠状动脉介入手术(PCI)后心肌再灌注损伤的影响。方法对拟行急诊PCI的160例AMI患者,分为别嘌醇组和对照组各80例,治疗3个月。分别测定术前、术后心肌酶谱及心肌肌钙蛋白(cTnI)、超氧化物歧化酶(SOD),以及术后24h内恶性心律失常发生率,常规检测术后3个月心功能、血脂、肝肾功、尿酸等指标。结果与对照组比较,别嘌醇组心肌酶谱及cTnI明显降低、SOD活力增加、术后24h恶性心律失常发生率降低、术后3个月时左心功能明显改善(均P<0.05),但两组血尿酸均降低差异无统计学意义(P>0.05),均无肝肾功能异常。结论别嘌醇预处理能减少AMI患者再灌注损伤中氧自由基的生成,降低恶性心律失常发生,减轻缺血心肌再灌注损伤。Objective To investigate the potential effects of allopurinol pretreatment in patients with acute myocardial infarc- tion who underwent percutaneous coronary intervention（PCI）. Methods 160 patients with acute ST segment elevation myocardial infarction （STEMI） who underwent primary percutaneous coronary intervention（PCI） were selected,and they were randomly divid- ed into allopurinol group（n= 80） and control group（n^80） and followed up for three months. Preoperative and postoperative myo- cardial enzymes and troponin,superoxide dismutase （SOD）, and the incidence of malignant arrhythmias within twenty four hours were recorded. We would record cardiac function,blood lipids,liver and kidney function, uric acid and other indicators three month later. Results Compared with the control group, the myocardial enzymes and troponin reduced significantly in allopurinol group, and the activity of SOD increased, the incidence of malignant arrhythmia within twenty-four hours reduced, the left ventricular func- tion significantly three month later improved （all P〈0. 05）. Both groups were lower serum uric acid but there was no difference, no kidney dysfunction. No event on liver and kidney dysfunction was noticed. Conclusion Pretreatment with allopurinol in patients with AMI reperfusion can reduce the generation of oxygen free radicals and the occurrence of malignant arrhythmias,alleviate myo- cardial ischemia and reperfusion injury as well.

关 键 词：再灌注损伤 别嘌醇 急性心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]