前列地尔脂肪乳剂对急性心肌梗死心肌缺血-再灌注损伤的保护作用  

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

作　　者：高航[1] 陶贵周[1] 孙志丹[2] 任铁丽[3] 

机构地区：[1]锦州医学院第一附属医院心内科,121001 [2]锦州医学院第一附属医院超声科,121001 [3]锦州医学院第一附属医院检验科,121001

出　　处：《国外医学（心血管疾病分册）》2003年第4期251-253,共3页

摘　　要：目的:探讨溶栓前应用前列地尔脂肪乳剂(Lipo-PGE_1)对急性心肌梗死(AMI)患者心肌缺血/再灌注(I/R)损伤的影响。方法:首次发病6h之内的AMI患者,予尿激酶溶栓治疗,临床再通者24例为对照组。在溶栓前予Lipo-PGE_110μg静脉注射临床再通者32例为前列地尔组。统计2h内心电图ST段抬高指数(∑STI)下降≥50％率与ST段完全回落率。记录再灌注心律失常(RA)。测定溶栓前即刻及溶栓后3h血清丙二醛(MDA)与超氧化物岐化酶(SOD)活性。2周后超声心动图检查测定梗死部位收缩期室壁增厚率(△T)、左室收缩末期容量(LVESV)与左室射血分数(LVEF)。结果:与对照组比较前列地尔组心电图∑STI下降≥50％率ST段完全回落率显著提高;频发室早与室速发生率降低;MDA与SOD再灌注前后的差值减少再灌注治疗2周后△T、LVEF均提高,LVESV减少。结论:Lipo-PGE_1可以减轻过氧化损伤,有助于溶栓后ST段完全回落,降低再灌注时室早、室速的发生率,改善左室功能。Objective: To investigate the effect of Lipo-prostaglandin E1(Lipo-PGE1)on myocardial ischemia reperfusion injury in patients with AMI. Methods:The patients with the first AMI(no more than six hours from the onset)were prospec-tively divided into two groups at random. Group 1 were treated with thrombolysis,and group 2 were given intravenous injection of Lipo-PGE1 and then were treated with thrombolytic therapy. There were 56 cases with clinical reperfusion, 24 cases in group 1, 32 cases in group 2. Reperfusion arrhythmia and changes of ST-segment elevated in eletrocardiogram within two hours were recorded continuously,SOD and MDA were measured before and three hours after thrombolysis. Two weeks later,echocardiogram were carried out to examine the extent of wall thickenness in systolic period(△T) ,LVESV,EF. Results: (1)The cases of ∑ STI reduction ≥50% and ST-segment recovery completely in group 2 were more than that in group 1 significantly. (2)The general accidents of RA were similar,but Lipo-PGEi were effective on prevention of ventricular premature beat and paroxysm ventricular tachycardia. (3) Lipo-PGE1 not only decreased the contents of MDA, but also increased the activities of SOD. (4)The △T and LVEF in group 2 were higher and the LVESV was diminished. Conclusions: Intravenous injection of Lipo-PGEi before thrombolysis has protective effects on myocardial reperfusion injury and improved the left ventricular contractive funtion.

关 键 词：急性心肌梗死 缺血-再灌注损伤 前列地尔脂肪乳剂 再灌注心律失常 过氧化损伤 

分 类 号：R542.22[医药卫生—心血管疾病]