α-硫辛酸对急性冠脉综合征患者心肌损伤保护作用的研究

摘要

Objective To investigate the protective effects of α-lipoic acid (α-LA) on myocardial injury of acute coronary syndrome patients. Methods 59 patients with acute coronary syndrome were randomized into two groups:conventional treatment group and α-LA group. 29 patients in conventional treatment group received routine drugs, while 30 patients inα-LA group were givenα-LA (600 mg/d, IVD, for 3 days) besides routine drugs. The activi-ty of ALDH2,level of MDA and LDH of serum in all patients were separately detected by microtitration,TBA and ELISA before and after treatment ( 24, 72 hours ),LVEF values were analyzed by UCG. Results ①There were no significant differences between the two groups before treatment. ②After 24 h and 72 h treatment, the activity of ALDH2 in two groups were increased ( P<0. 01 ) and the level of MDA was decreased ( P<0. 01 ) compared to the data before treatment. Compared to after 24 h, the level of LDH was reduced after 72 h (P<0. 01) and the LVEF values were significantly higher after 72 h and 1 week (P<0. 05). ③Compared to conventional treatment group, the activity of ALDH2 inα-LA group was significantly increased ( P<0. 01 ) and the levels of MDA and LDH were decreased after 24 h and 72 h ( P<0. 05 , P<0. 01 ) . The LVEF values were significantly increased after 1 week (P<0. 05). Conclusion α-LA may increase the ALDH2 activity, reduce peroxidation end product (MDA) gen-eration of serum in ACS patients, and finally decline oxidative damage to myocardial ischemia and reperfusion ( the level of LDH decreased) .%目的：探讨α-硫辛酸(α-LA )对急性冠脉综合征( ACS)患者心肌损伤的保护作用。方法研究对象为59例急性冠脉综合征患者,随机分为常规药物治疗组和α-LA组。常规药物组29例给予抗栓、调脂、扩管药物治疗；α-LA组30例在常规药物治疗基础上加用α-LA(600 mg/d,IVD,疗程3d)。2组在用药前0 h、用药后24 h和72 h各采取静脉血4~5 ml,采用 ELISA 法测定血清乙醛脱氢酶2(ALDH2)活性,硫代苯巴比妥酸法测定血清丙二醛(MDA)水平,微量酶标法测定血清乳酸脱氢酶(LDH)含量,LVEF通过心脏彩色多普勒超声心动图检查测定。结果①两组在用药前0 h的血清ALDH2活性、MDA及LDH水平、LVEF值无显著差异；②两组在用药24 h 和72 h后血清ALDH2活性水平较用药前0 h明显上升(P<0.01),MDA较用药前0 h显著下降(P<0.01)；LDH水平在用药72 h较24 h显著下降(P<0．01),LVEF值72 h和1周后均有明显升高(P<0．05)；③与常规治疗组比较,α-LA组在用药24 h及72 h后血清ALDH2活性均显著上升(P<0．01),MDA水平显著下降(P<0．05),LDH亦显著下降(P<0．01),LVEF值1周后升高更显著( P<0．05)。结论α-LA 上调 ACS 患者的ALDH2活性,减少过氧化终产物MDA的生成,减轻心肌组织缺血及缺血再灌注后的氧化损伤( LDH水平回降)。