氧化应激在急性心肌梗死直接PCI后心肌灌注不良中的作用  

The relationship between oxidative stress and myocardial perfusion in patients with acute myocardial infarction after primary percutaneous coronary intervention

作　　者：黄广勇[1] 杨文波[2,3] 刘静雯[1] 杨兰菊[1] 

机构地区：[1]泰山医学院聊城临床学院(聊城市人民医院)心内科山,东省聊城市252000 [2]上海交通大学医学院附属瑞金医院心内科 [3]上海交通大学医学院心血管病研究所

出　　处：《中国心血管病研究》2017年第2期126-129,共4页Chinese Journal of Cardiovascular Research

基　　金：山东省医药卫生科技发展计划项目（项目编号：2013WS0090）

摘　　要：目的探讨氧化应激与急性心肌梗死（STEMI）直接经皮冠脉介入治疗（PCI）后心肌灌注不良的关系。方法选择连续就诊并且行直接PCI的STEMI患者148例，采集主动脉窦动脉血，测定丙二醛（MDA）含量、超氧化物歧化酶（SOD）活性，应用心电图sT段回落率及TMP分级评价心肌灌注。以稳定型心绞痛（SAP）患者40例及健康人40名作为对照。结果148例患者中，心肌灌注良好组116例，心肌灌注不良组32例。STEMI组、SAP组和正常对照组MDA分别为（6．20±1．62）nmol／ml、（5．24±2．10）nmol／ml和（4．08＋1．48）nmol／ml，STEMI组MDA明显高于SAP组和正常对照组（P〈O．05）；STEMI组SOD活性明显高于正常对照组（P〈0．05）。心肌灌注不良组和心肌灌注良好组MDA分别为（6．77±1．61）nmol／rnl和（5．92±1．55）nmol／ml，两组比较差异有统计字意义（P〈0．05）。Logistic回归分析结果显示，MDA的OR为1．44（95％C10．81～2．57）。结论氧化应激与急性心肌梗死直接PCI后心肌灌注不良有关。Objective To explore the relationship between oxidative stress and poor myocardial perfusion in patients with acute ST-segment elevation myocardial infarction （STEMI） after primary percutaneous coronary intervention （PCI）. Methods A total of 148 STEMI patients who underwent primary PCI were divided into good and poor perfusion groups by sum-ST-segment resolution and TMP grade. Aortic sinus arterial blood was collected. The malondialdehyde（MDA） and superoxide dismutase（SOD） were measured by chemical colorimetry. 40 stable angina patients and 40 healthy persons were collected as control groups. Results The good and poor perfusion patients were 116 and 32, respectively. The level of MDA in STEMI patients, stable angina patients and healthy persons were （6.20±1.62）nmol/ml, （5.24±2.10）nmol/ml and （4.08±1.48）nmol/ml, respectively. The level of MDA in STEMI group was significantly higher than stable angina and healthy persons groups （P〈0.05）. The level of SOD was higher in STEMI group than healthy persons groups （P〈0.05）. The level of MDA in the poor perfusion group and good perfusion group were （6.77±1.61）nmol/ml and （5.92±1.55）nmol/ml, respectively. The level of MDA was significantly higher in the poor perfusion group than the good perfusion group （P〈0.05）. Logistic regression showed that OR for MDA was 1.44 （95% CI 0.81-2.57）. Conclusion Oxidative stress is related to poor myocar dial perfusion in patients with STEMI after primary PCI.

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入治疗术 氧化应激 丙二醛 

分 类 号：R542.22[医药卫生—心血管疾病]