硝酸异山梨酯对STEMI患者心肌缺血再灌注损伤的后处理效应  

After-treatment effect of isosorbide dinitrate on myocardial ischemia-reperfusion injury in STEMI patients

作　　者：杜正强[1] 刘盼 梅少平[3] 宋达琳[1] DU Zheng-qiang;LIU Pan;MEI Shao-ping;SONG Da-lin(Qingdao Municipal Hospital,Qingdao 266071,China;Xiangyang No.1 People's Hospital,Xiangyang 441000,China;Affiliated Hospital of Qingdao University,Qingdao 266002,China)

机构地区：[1]青岛市市立医院,山东青岛266071 [2]襄阳市第一人民医院老年病科,湖北襄阳441000 [3]青岛大学附属医院,山东青岛266002

出　　处：《中国药物应用与监测》2019年第6期331-334,共4页Chinese Journal of Drug Application and Monitoring

基　　金：中国医师协会探索心血管研究基金项目(DFCMDA201303)

摘　　要：目的:探讨急性ST段抬高型心肌梗死(STEMI)患者PCI术中实施硝酸异山梨酯(异舒吉)后处理对心肌缺血再灌注损伤是否具有保护作用,及血清炎症因子、肿瘤坏死因子-α(TNF-α)的变化情况。方法:将符合条件的STEMI患者行PCI手术,随机分为常规PCI组(A组)、硝酸异山梨酯后处理PCI组(B组),用ELISA方法检测两组患者PCI术前,术后2 h、1 d、4d、7 d血清肌钙蛋白I(cTnI)和TNF-α浓度。结果:术前cTnI和TNF-α水平两组之间无统计学差异。B组术后4 d、7 d cTnI水平较A组下降,差异有统计学意义(P<0.05)。B组术后1 d、4 d、7 d TNF-α水平较A组下降,差异有统计学意义(P<0.05)。结论:STEMI患者PCI治疗过程中实施硝酸异山梨酯后处理,可降低PCI术后TNF-α水平,硝酸异山梨酯后处理可能具有减轻心肌缺血再灌注损伤后炎症反应的作用。Objective:To investigate the protective effect of after-treatment with isosorbide dinitrate(isoket)on myocardial ischemia-reperfusion injury and its regulatory effect on serum inflammatory factors,TNF-αin acute ST-elevation myocardial infarction(STEMI)patients during percutaneous coronary intervention(PCI).Methods:Patients with STEMI who would be treated with PCI were randomly divided into PCI standardized treatment group(32 cases,A group)and isosorbide dinitrate after-treatment group(32 cases,B group).The serum concentrations of cTnI,TNF-αbefore PCI and 2 hours,1 day,4 days and 7 days after PCI were detected by enzyme linked immunosorbent assay(ELISA).Results:The concentrations of cTnI and TNF-αin two groups had no statistical differences before PCI.The concentrations of cTnI at the 4 th day and 7 th day after PCI in B group were significantly lower than those of A group(P<0.05).The concentrations of TNF-αat the 1 st day,4 th day and 7 th day after PCI in B group were significantly lower than those of A group(P<0.05).Conclusion:After-treatment with isosorbide dinitrate(isoket)during PCI in patients with STEMI could reduce the serum concentration of TNF-αafter PCI,which indicated that after-treatment with isosorbide dinitrate(isoket)might reduce the inflammatory response of myocardial ischemia-reperfusion injury.

关 键 词：缺血再灌注损伤 药物后处理 硝酸异山梨酯 TNF-Α 

分 类 号：R969.4[医药卫生—药理学]