依达拉奉对急性心肌梗死患者CABG术后心肌保护作用及对血清TNF-α、IL-6、NO水平的影响

摘要

目的 观察依达拉奉对急性心肌梗死患者冠状动脉旁路移植(CABG)术后心肌保护作用及其对血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、一氧化氮(NO)水平的影响.方法 选取郑州大学附属洛阳中心医院心脏血管外科收治的拟行CABG术的急性心肌梗死患者106例作为研究对象,按照随机数字表法分为观察组和对照组各53例,其中对照组在术后给予常规治疗,观察组在对照组基础上联合依达拉奉治疗.观察两组临床疗效、左室收缩末内径(LVESD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)、乳酸脱氢酶(LDH)、肌钙蛋白(cTnT)、肌酸激酶同工酶(CK-MB)及血清TNF-α、IL-6、NO水平的变化.结果 观察组总有效率92.45%显著高于对照组77.36%(P<0.05);术后2周两组LVESD、LVEDD水平显著低于术前(P<0.05),且观察组显著低于对照组(P<0.05),两组LVEF水平显著高于术前(P<0.05),且观察组显著高于对照组(P<0.05);术后1周、术后2周两组LDH、cTnT、CK-MB水平显著高于术前(P<0.05),且观察组显著低于对照组(P<0.05),术后2周LDH、cTnT、CK-MB水平显著低于术后1周(P<0.05),且观察组显著低于对照组(P<0.05);术后2周两组TNF-α、IL-6水平显著低于术前(P<0.05),且观察组显著低于对照组(P<0.05),两组NO水平显著高于术前(P<0.05),且观察组显著高于对照组(P<0.05).结论 采用依达拉奉治疗急性心肌梗死行CABG术的患者,可有效控制血清TNF-α、IL-6、NO水平,从而保护心肌细胞,改善心功能,提高临床疗效.%Objective To observe the myocardial protection of Edaravone in treatment of acute myocardial infarction after coronary artery bypass grafting (CABG) surgery and changes of serum tumor necrosis factor α (TNF- α), interleukin -6 (IL-6), nitric oxide (NO) levels. Methods 106 patients with acute myocardial infarction undergoing CABG surgery in our hospital were selected, and were divided into observation group and control group according to random number table method, 53 patients in each group. The control group were given routine treatment after surgery, and the observation group were combined with Edaravone treatment. Clinical effect, left ventricular end systolic diameter (LVESD), left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), lactate dehydrogenase (LDH) and cardiac troponin (cTnT), creatine kinase isoenzyme (CK-MB) and changes of serum TNF-α, IL-6, NO levels were observed in the two groups. Results The total effective rate of the observation group was 92.45%, significantly higher than that of 77.36% of the control group (P<0.05). At 2 weeks after surgery, LVESD and LVEDD levels were significantly lower than those before operation (P<0.05), and those in the observation group were significantly lower than those in the control group (P<0.05). LVEF was significantly higher than that before operation (P<0.05), and that in the observation group was significantly higher than in the control group (P<0.05). At 1 week, 2 weeks after surgery, LDH, cTnT and CK-MB levels were significantly higher than those before surgery in the two groups (P<0.05), and LDH, cTnT and CK-MB levels in the observation group were significantly lower than those in the control group (P<0.05). LDH, cTnT, CK-MB levels at 2 weeks after surgery were significantly lower than those at 1 week after surgery (P<0.05), and LDH, cTnT, CK-MB levels in the observation group were significantly lower than those in the control group (P<0.05). After 2 weeks, TNF- α and IL-6 levels were significantly lower than those before surgery (P<0.05), and TNF- α and IL-6 levels in the observation group were significantly lower than those in the control group (P<0.05). NO level was significantly higher than that before surgery in the two groups (P<0.05), and NO level in the observation group were significantly higher than those in the control group (P<0.05). Conclusion Edaravone can effectively control serum TNF- α and IL-6 levels in treatment of acute myocardial infarction after CABG surgery, protect cardiomyocytes, and improve heart function and clinical effect.