乌司他丁对急诊PCI术后心肌缺血再灌注损伤的影响

摘要

目的：考察乌司他丁对急诊 PCI术后心肌缺血再灌注损伤的影响及其分子机制。方法将120例接受急诊 PCI治疗病人随机分为观察组和对照组,每组60例。对照组给予常规急诊PCI治疗,观察组在术后额外使用乌司他丁1×104 U/kg治疗。比较两组病人脂联素(APN)、肿瘤坏死因子α(TNF α)、心肌缺血再灌注损伤临床事件及心肌磷酸激酶同工酶(CK MB)浓度时间曲线下面积的差异。结果观察组术后各时段APN显著高于对照组(t=2.725,t=3.802,P<0.01),TNF α水平显著低于对照组(t=4.298,t=5.190,P<0.01)。观察组心肌缺血再灌注损伤临床事件发生率显著低于对照组(χ2=5.763,P<0.01)。CK MB浓度时间曲线下面积显著低于对照组(t=32.694,P<0.01)。结论乌司他丁具有拮抗心肌缺血病人炎性过度激活保护再灌注损伤的临床治疗效果。%Objective To investigate the effects and its mechanism of ulinastatin on myocardial ischemia reperfusion injury after emer-gency percutaneous coronary intervention (PCI). Methods One hundred and twenty patients undergoing directed PCI were random-ly divided into observation group and control group,60 cases in each group. The control group were given routine emergency PCI treatment,the observation group were treated with ulinastatin 10 000 U/kg additional y. The levels of adiponectin (APN),tumor nec-rosis factor alpha (TNF α),myocardial ischemia and reperfusion injury rate,and the area of creatine kinase MB (CK MB)con-centration time curve in two groups were compared. Results The levels of TNF αin the observation group were significantly lower than those in the control group(t=4.298,t=5.190,P<0.01),but APN was significantly higher (t=2.725,t=3.802,P<0.01). The incidence of myocardial ischemia reperfusion injury in the observation group was significantly lower than that in the control group (χ2=5.763,P<0.01). The area under the CK MB concentration time curve was significantly lower than that in the control group (t=32.694,P<0.01). Conclusion Ulinastatin can inhibit the inflammatory excessive activation to prevent reperfusion injury in pa-tients with myocardial ischemia.