前列地尔对经皮冠状动脉介入术后患者心肌保护作用及炎性因子和氧化应激的影响  

Effects of alprostadil on myocardial protection,inflammatory factors and oxidative stress in patients with acute ST segment elevation myocardial infarction after PCI

作　　者：阮政文[1] Ruan Zhengwen(Department of Cardiology,the People's Hospital of Yuyao,Yuyao,Zhejiang,315400,China)

机构地区：[1]余姚市人民医院心内科,浙江省315400

出　　处：《中国基层医药》2020年第15期1813-1817,共5页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨前列地尔对急性ST段抬高型心肌梗死(STEMI)行经皮冠状动脉介入术(PCI)术后患者心肌保护作用及炎性因子和氧化应激的影响。方法选取余姚市人民医院2018年12月至2019年12月行PCI术的STEMI患者150例,采用随机数字表法分为观察组75例与对照组75例。对照组采用常规治疗,观察组在对照组基础上联合前列地尔治疗。两组疗程均为14 d。比较两组治疗前后心功能、心肌酶、炎性因子和氧化应激水平变化。结果观察组治疗后左心室射血分数[(52.31±3.25)%]高于对照组[(47.28±2.19)%],而左室舒张末期内径[(42.13±4.35)mm]低于对照组[(48.24±3.90)mm],差异均有统计学意义(t=11.115、9.057,均P<0.05);观察组治疗后肌酸激酶同工酶[(15.42±2.80)μg/L]低于对照组[(21.13±2.35)μg/L],而肌钙蛋白T[(0.37±0.06)μg/L]高于对照组[(0.26±0.05)μg/L],差异均有统计学意义(t=13.528、16.337,均P<0.05);观察组治疗后肿瘤坏死因子α[(6.47±1.36)ng/L]、白细胞介素6[(7.03±1.20)ng/L]、超敏C反应蛋白[(3.27±0.87)mg/L]均低于对照组[(9.82±2.01)ng/L、(11.21±1.73)ng/L、(5.96±1.07)mg/L](t=11.954、17.193、12.199,均P<0.05)。观察组治疗后超氧化物歧化酶[(89.72±10.21)U/L]高于对照组[(71.31±9.78)U/L],而观察组丙二醛[(8.21±1.45)μmol/L]低于对照组[(11.26±1.78)μmol/L],差异均有统计学意义(t=11.277、11.505,均P<0.05)。结论前列地尔对STEMI行PCI术后患者心肌具有良好保护作用,且可减轻炎性反应及改善患者氧化应激反应。Objective To investigate the effects of alprostadil on myocardial protection,inflammatory factors and oxidative stress in patients with acute ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods From December 2018 to December 2019,150 STEMI patients who underwent PCI in the People's Hospital of Yuyao were divided into observation group(75 cases)and control group(75 cases)according to the random digital table method.The patients in the control group were treated with routine therapy,while those in the observation group were treated with alprostadil on the basis of the control group.The course of treatment in both two groups was 14 days.The changes of cardiac function,myocardial enzymes,inflammatory factors and oxidative stress were compared before and after treatment.Results The LVEF[(52.31±3.25)%]in the observation group was higher than that in the control group[(47.28±2.19)%],and the LVEDd[(42.13±4.35)mm]in the observation group was lower than that in the control group[(48.24±3.90)mm],the differences were statistically significant(t=11.115,9.057,all P<0.05).After treatment,the CK-MB[(15.42±2.80)μg/L]in the observation group was lower than that in the control group[(21.13±2.35)μg/L],while the cTnT[(0.37±0.06)μg/L]in the observation group was higher than that in the control group[(0.26±0.05)μg/L],the differences were statistically significant(t=13.528,16.337,all P<0.05).After treatment,the levels of TNF-α[(6.47±1.36)ng/L],IL-6[(7.03±1.20)ng/L]and hs-CRP[(3.27±0.87)mg/L]in the observation group were lower than those in the control group[(9.82±2.01)ng/L,(11.21±1.73)ng/L and(5.96±1.07)mg/L](t=11.954,17.193 and 12.199,all P<0.05).After treatment,the SOD[(89.72±10.21)U/L]in the observation group was higher than that in the control group[(71.31±9.78)U/L],the MDA[(8.21±1.45)μmol/L]in the observation group was lower than that in the control group[(11.26±1.78)μmol/L],the differences were statistically significant(t=11.277,11.505,all P<0.05).Conclusi

关 键 词：经皮冠状动脉介入疗法 心肌梗死 心功能 心肌酶 炎性因子 氧化应激 前列地尔 

分 类 号：R541.4[医药卫生—心血管疾病]