前列地尔脂肪乳剂对急性心肌梗死微循环再灌注的影响  

The protective effect of lipo-prostaglandin E_1 on microcirculation reperfusion in patients with acute myocardial infarction

作　　者：高航[1] 周建新 陶贵周[1] 

机构地区：[1]锦州医学院第一附属医院心内科,辽宁锦州121001 [2]盘锦监狱医院内科

出　　处：《临床心血管病杂志》2003年第7期398-400,共3页Journal of Clinical Cardiology

摘　　要：目的 :探讨前列地尔脂肪乳剂 (Lipo PGE1)对急性心肌梗死 (AMI)溶栓后微循环再灌注的影响。方法 :首次发病 6h之内的AMI溶栓治疗判为临床再通者 5 6例分为 :对照组 ,2 4例 ;Lipo PGE1组 ,32例。后者溶栓前予Lipo PGE110 μg静脉注射 ,余治疗同对照组。统计 2h内心电图ST段抬高指数 (∑STI)下降≥ 5 0 %率与ST段完全回落率。测量溶栓前及溶栓后 2 4h的QRS积分。测定溶栓前即刻及溶栓后 2h、10h血小板聚集率。结果 :Lipo PGE1组与对照组比较 :①心电图∑STI下降≥ 5 0 %率、ST段完全回落率均显著提高 (96 .9%∶75 .0 % ,P <0 .0 5 ;84 .4 %∶5 8.3% ,P <0 .0 5 ) ;②溶栓后 2h两组血小板聚集率Lipo PGE1组明显低于对照组 [(31±18) %∶(4 5± 2 2 ) % ,P <0 .0 1],10h两组相同 [(15± 7) %∶(13± 6 ) % ,P >0 .0 5 ];③溶栓治疗后 2 4hLipo PGE1组QRS积分明显低于对照组 (5 .2± 0 .3∶5 .9± 0 .4 ,P <0 .0 5 )。结论 :Lipo PGE1能通过迅速抑制血小板功能 ,减轻心肌微循环的无复流现象 。Objective: To investigate the effect and the mechanism of Lipo PGE 1on microcirculation reperfusion in patients with Acute Myocardial Infarction (AMI).Methods:The patients with the first AMI (the onset system within six hours from the onset) were divided into two groups at random. One was treated with thrombolysis, and the other was given intravenous injection of Lipo PGE 1 before thrombolytic therapy. The patients with clinical reperfusion were classified to control group (24 cases) and Lipo PGE 1 group (32 cases) respectively. To record the 18 lead elctrocardiogram before and two hours and twenty four hours after thrombolysis, and test the platelet aggregation before and two hours and ten hours hours after thrombolysis.Results:①The cases of ∑STI resolution ≥50% and ST segment recovery completely in Lipo PGE 1 group were more than that in control group significantly( 96.9 % vs 75.0 %,P< 0.05 ; 84.4 % vs 58.3 %,P< 0.05 ). ②The rate of platelet aggregation two hours after thrombolysis in Lipo PGE 1 group were lower than in control group significantly[(31±18)% vs (45±22)%,P< 0.01 ] and those ten hours after thrombolysis were similar[(15±7)% vs (13±6)%,P> 0.05 ]. ③The QRS score twenty four hours after thrombolysis in Lipo PGE 1 group were less than that in control group significantly( 5.2 ± 0.3 vs 5.9 ± 0.4 ,P< 0.05 ).Conclusion:Intravenous injection of Lipo PGE 1 before thrombolysis has protective effects on microcirculation reperfusion and can decress the infarction size. It may be related to inhibit platelet microthrombo embolism and maintain the microvascular flow.

关 键 词：心肌梗死 心肌再灌注 前列地尔脂肪乳剂 血栓溶解疗法 

分 类 号：R542.2[医药卫生—心血管疾病]