Objective To observe the effect of erythropoietin (EPO) on reperfusion arrhythmia after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods A prospective randomized controlled study was conducted and included 75 patients with STEMI who underwent PCI in our center from January 2016 to June 2018. Before PCI, the observation group (n= 38) received intravenous preoperative EPO 100 U/kg + 100 ml 0. 9％ NS, and control group (n = 37) received 100 ml 0. 9％ NS. The incidence of postoperative arrhythmia and incidence of major adverse cardiac events (MACE) were compared between two groups. The preoperative and postoperative cardiac function (EV, AV), myocardial injury markers (ICTP, CysC), inflammatory factors (CRP, IL-10) were compared between two groups. Results The incidence of arrhythmia (44. 7％ vs 73. 0％) and MACE (5. 3％ vs 32. 4％) were lower in observation group than in control group (P ＜ 0. 05). The postoperative EV, AV, IL-10 were higher and postoperative ICTP, CysC and CRP were lower than before operation (P ＜ 0. 05). The differences of EV, AV, ICTP, CysC, CRP and IL-10 were statistically significant between two groups (P ＜0. 05). Conclusion EPO can relieve perfusion arrhythmia after PCI in STEMI patients. Improved myocardial function, relieved myocardial damage and inhibited inflammatory response might be the associated mechanism.%目的 观察促红细胞生成素(EPO)对ST段抬高型心肌梗死(ETEMI)患者经皮冠状动脉介入(PCI)治疗术后再灌注性心律失常的影响.方法 采用前瞻性随机对照研究的方法,选择2016年1月至2018年6月辽宁省本溪市中心医院收治的75例行PCI治疗的ETEMI患者作为研究对象,随机分为两组,观察组(n=38)患者PCI术前给予EPO 100 U/kg+100 ml 0.9％氯化钠溶液静脉滴注,对照组(n=37)患者PCI术前仅给予100 ml 0.9％氯化钠溶液静脉滴注.比较两组患者术后心律失常的发生率和主要不良心脏事件(MACE)的发生情况,统计两组患者PCI术前及术后心功能(EV、AV)、心肌损伤标志物(ICTP、Cys C)以及炎性因子(CRP、IL-10)含量.结果 观察组患者的心律失常发生率(44.7％vs.73.0％)与MACE发生率(5.3％vs.32.4％)均低于对照组(P ＜0.05);两组患者术后的EV、AV、IL-10均较术前升高,ICTP、Cys C、CRP均较术前降低(P ＜0.05),术后EV、AV、ICTP、Cys C、CRP、IL-10组间比较差异均具有统计学意义(P ＜0.05).结论 EPO对ETEMI患者PCI术后再灌注性心律失常有一定的缓解作用;推测改善心肌泵血功能、减轻心肌细胞损伤以及抑制炎症反应是其主要作用机制.
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