急性ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗术后无复流患者红细胞渗透脆性变化及其机制研究  

Change of Erythrocyte Osmotic Fragility of Postoperative No- reflow ASTEMI Patients Treated by Emergency PCI and Its Mechanism

作　　者：屈晓威[1] 冯莉莉[1] 马利军[1] 刘亚东[1] 

机构地区：[1]延安大学附属医院检验科,陕西省延安市716000

出　　处：《实用心脑肺血管病杂志》2016年第4期9-11,共3页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：陕西省科技厅自然基金项目(2014JC2-21585)

摘　　要：目的分析急性ST段抬高型心肌梗死(ASTEMI)急诊经皮冠状动脉介入治疗(PCI)术后无复流患者红细胞渗透脆性变化及其机制。方法选取延安大学附属医院急诊科2014年1月—2015年10月收治的行急诊PCI的ASTEMI患者150例,根据患者术后是否出现无复流分为无复流组84例和复流组66例。比较两组患者入院时和术后红细胞渗透脆性指标差值〔包括红细胞脆性最小抵抗值差值(ΔOF_(min))、红细胞脆性最大抵抗值差值(ΔOF_(max))、ΔPBS浓度为5 M时溶血率、ΔPBS浓度为6 M时溶血率、ΔPBS浓度为7 M时溶血率及平均红细胞体积差值(ΔMCV)〕,入院时、术后红细胞膜Na^+-K^+-ATP酶活性及血浆丙二醛(MDA)、超氧化物歧化酶(SOD)水平。结果复流组患者ΔOF_(min)、ΔOF_(max)、ΔPBS浓度为5 M时溶血率、ΔPBS浓度为6 M时溶血率、ΔPBS浓度为7 M时溶血率及ΔMCV均小于复流组(P<0.05)。入院时两组患者红细胞膜Na^+-K^+-ATP酶活性及血浆MDA、SOD水平比较,差异无统计学意义(P>0.05);术后复流组患者红细胞膜Na^+-K^+-ATP酶活性和血浆SOD水平高于无复流组,血浆MDA水平低于无复流组(P<0.05)。结论 ASTEMI急诊PCI术后无复流患者红细胞渗透脆性明显增加,可能与红细胞膜Na^+-K^+-ATP酶活性降低及氧化应激反应增强有关。Objective To analyze the change of erythrocyte osmotic fragility of postoperative no- reflow ASTEMI patients treated by emergency PCI and its mechanism. Methods From January 2014 to October 2015,a total of 150 patients with ASTEMI were selected in the Department of Emergency, Yan＇ an University Affiliated Hospital, all of them received emergency PCI. According to the incidence of no- reflow,all of the patients were divided into A group（ with no- reflow,n =84） and B group（ without no- reflow,n = 66）. Difference value of erythrocyte osmotic fragility related index at admission and after PCI 〔including red brittleness minimum resistance value difference（ ΔOF_（min））,red brittleness maximum resistance value difference（ ΔOF_（max））,hemolytic rate when ΔPBS reached to 5 M,hemolytic rate when ΔPBS reached to 6 M,hemolytic rate when ΔPBS reached to 7 M and mean corpuscular volume difference（ ΔMCV） 〕, erythrocyte membrane enzymatic activity of Na-＋- K-＋- ATP,plasma levels of MDA and SOD were compared between the two groups at admission and after PCI. ResultsΔOF_（min）,ΔOF_（max）,hemolytic rate when ΔPBS reached to 5 M,hemolytic rate when ΔPBS reached to 6 M,hemolytic rate whenΔPBS reached to 7 M and ΔMCV of B group were statistically significantly smaller than those of A group（ P〈0. 05）. No statistically significant differences of erythrocyte membrane enzymatic activity of Na-＋- K-＋- ATP,plasma level of MDA or SOD was found between the two groups at admission（ P〈0. 05）; after PCI,erythrocyte membrane enzymatic activity of Na-＋- K-＋-ATP and plasma SOD level of B group were statistically significantly higher than those of A group,while plasma MDA level of B group was statistically significantly lower than that of A group（ P〈0. 05）. Conclusion The erythrocyte osmotic fragility of postoperative no- reflow ASTEMI patients treated by emergency PCI obviously increases, the mechanism may relate to the decrease of erythrocyte membrane enzymatic activit

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 无复流现象 红细胞 渗透脆性 

分 类 号：R542.22[医药卫生—心血管疾病]