尼可地尔联合国产重组人脑利钠肽对AMI急诊PCI术后慢血流患者红细胞渗透脆性及氧化应激损伤的影响
|
摘要
目的:探讨尼可地尔联合国产重组人脑利钠肽对急性心肌梗死(AMI)急诊PCI术后慢血流患者红细胞渗透脆性及氧化应激损伤的影响。方法:将2016-06-2017-06我院收治的急诊PCI术后发生慢血流的患者90例随机分为观察组与对照组,每组各45例。其中对照组在常规治疗基础上加用尼可地尔,观察组则在常规治疗基础上加用尼可地尔联合国产重组人脑利钠肽。对比两组患者心肌灌注情况、心功能、红细胞渗透性及氧化应激指标水平差异。结果:术后第7天,观察组室壁运动积分指数(WMSI)与左心室收缩末期容积指数(LVESVI)明显低于对照组,左室射血分数(LVEF)明显高于对照组(均P<0.05)。观察组髓过氧化物酶(MPO)、丙二醛(MDA)、红细胞渗透脆性最大抵抗值(OFmax)、红细胞渗透脆性最小抵抗值(OFmix)、红细胞平均体积(MCV)、溶血率(0.45/0)及溶血率(0.45/0.15)水平明显低于对照组(均P<0.05);超氧化物歧化酶Orgotein(SOD)及NQO-1水平均高于对照组(均P<0.05)。结论:尼可地尔联合国产重组人脑利钠肽可明显降低AMI急诊PCI术后慢血流患者氧化应激损伤,提高红细胞渗透脆性,改善心功能及血流灌注能力。
Objective:To investigate effects of nicorandil combined with natriuretic peptide on erythrocyte osmotic fragility and oxidative stress injury in slow blood flow patients with acute myocardial infarction (AMI) after emergency PCI.Method:Ninety patients with slow blood flow after emergency PCI who were admitted to our hospital from June 2016 to June 2017 were randomly divided into observation group and control group with 45 people in each group.Patients in control group were given nicorandil on the basis of conventional treatment,and patients in observation group were given nicorandil combined with natriuretic peptide on the basis of conventional treatment.Differences in myocardial perfusion,cardiac function,erythrocyte permeability,and oxidative stress were compared between the two groups.Result:On the 7th day after surgery,the wall motion score index (WMSI)and left ventricular end-systolic volume index (LVESVI)were significantly lower,while the left ventricular ejection fraction (LVEF)was significantly higher in observation group than those in control group (all P<0.05).Myeloperoxidase (MPO),malondialdehyde (MDA),erythrocyte osmotic fragility maximum resistance value (OFmax),erythrocyte osmotic fragility minimum resistance value (OFmix),mean corpuscular volume (MCV)and hemolysis rate (0.45/0.15) level were significantly lower,while superoxide dismutase orgotein (superoxide dismutase,SOD)and NQO-1 were higher in observation group than those in control group (all P<0.05).Conclusion:Nicorandil combined with natriuretic peptide can significantly reduce oxidative stress injury in slow blood flow patients with AMI after emergency PCI,which can improve erythrocyte osmotic fragility,cardiac function and blood perfusion ability.
Objective:To investigate effects of nicorandil combined with natriuretic peptide on erythrocyte osmotic fragility and oxidative stress injury in slow blood flow patients with acute myocardial infarction (AMI) after emergency PCI.Method:Ninety patients with slow blood flow after emergency PCI who were admitted to our hospital from June 2016 to June 2017 were randomly divided into observation group and control group with 45 people in each group.Patients in control group were given nicorandil on the basis of conventional treatment,and patients in observation group were given nicorandil combined with natriuretic peptide on the basis of conventional treatment.Differences in myocardial perfusion,cardiac function,erythrocyte permeability,and oxidative stress were compared between the two groups.Result:On the 7th day after surgery,the wall motion score index (WMSI)and left ventricular end-systolic volume index (LVESVI)were significantly lower,while the left ventricular ejection fraction (LVEF)was significantly higher in observation group than those in control group (all P<0.05).Myeloperoxidase (MPO),malondialdehyde (MDA),erythrocyte osmotic fragility maximum resistance value (OFmax),erythrocyte osmotic fragility minimum resistance value (OFmix),mean corpuscular volume (MCV)and hemolysis rate (0.45/0.15) level were significantly lower,while superoxide dismutase orgotein (superoxide dismutase,SOD)and NQO-1 were higher in observation group than those in control group (all P<0.05).Conclusion:Nicorandil combined with natriuretic peptide can significantly reduce oxidative stress injury in slow blood flow patients with AMI after emergency PCI,which can improve erythrocyte osmotic fragility,cardiac function and blood perfusion ability.
引文
[1]Ibrahim AW,Riddell TC,Devireddy CM.Acute myocardial infarction[J].Crit Care Clin,2014,30(3):341-364.
[2]杨树森,甘润韬,孙延明,等.阿托伐他汀对ST段抬高型急性心肌梗死患者急诊PCI术后无复流现象的影响[J].临床心血管病杂志,2011,27(1):35-38.
[3]Arslan U,YamaN M,Kocao4lu,et al.Risk of no-reflow in culprit lesion versus culprit vessel PCI in acute STEMI[J].Coron Artery Dis,2015,26(6):510-515.
[4]祖秀光,刘素云,郝玉明,等.冠状动脉慢血流现象的临床意义[J].临床心血管病杂志,2007,23(12):900-902.
[5]牛君义,崔晓迎.影响急诊急性心肌梗死PCI术中慢血流和无复流相关因素分析[J].中华肿瘤防治杂志,2016,23(s2):165-166.
[6]Sun C,Zhi J,Bai X,et al.Comparison of the efficacy of recombinant human brain natriuretic peptide with saline hydration in preventing contrast-induced nephropathy in patients undergoing coronary angiography with or without concomitant percutaneous coronary intervention[J].Int J Clin Exp Med,2015,8(8):14166-14172.
[7]Hirohata A,Yamamoto K,Hirose E,et al.Nicorandil prevents microvascular dysfunction resulting from PCIin patients with stable angina pectoris:a randomised study.[J].EuroIntervention,2014,9(9):1050-1056.
[8]中华医学会心血管病学分会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(2):713-714.
[9]肖燕,杨丽娜,孙琴.氯吡格雷和替格瑞洛对急性ST段抬高型心肌梗死患者经皮冠状动脉介入术后TIMI分级及心功能影响的对比研究[J].实用心脑肺血管病杂志,2017,25(10):72-75.
[10]Wang XF,Ye M,Yan D,et al.Non-invasive ventilation improves hemorheology status in hypoxemic patients with acute myocardial infarction after PCI[J].J Geriatr Cardiol,2017,14(4):274-279.
[11]Liu WB,Zou ZP,Jiang HP,et al.Clinical significance of dynamic changes in hs-CRP and ADAMTS13levels in the blood serum of patients with no-reflow after PCI operation[J].Eur Rev Med Pharmacol Sci,2016,20(19):4148-4155.
[12]郇雷,刘红岩,亓华新,等.急诊PCI术后无复流STE-MI患者红细胞渗透脆性的变化[J].中国循证心血管医学杂志,2016,8(6):712-714.
[13]何伟民,黄景文,罗韶金,等.替格瑞洛联合比伐芦定对急性ST段抬高型心肌梗死患者急诊PCI术中无复流/慢血流的作用[J].血栓与止血学,2017,23(3):400-402.
[14]葛慧娟.重组人脑利钠肽对于急性心肌梗死后老年心力衰竭患者疗效及预后的影响[J].中国老年学,2016,36(3):602-604.
[15]Kawai Y,Hisamatsu K,Matsubara H,et al.Intravenous administration of nicorandil immediately before percutaneous coronary intervention can prevent slow coronary flow phenomenon[J].Eur Heart J,2009,30(7):765-772.
[16]杨倩倩,崔建国,王树娟,等.冠状动脉慢血流患者的影响因素分析[J].中国循环杂志,2017,32(9):877-881.
[17]Kato D,Takashima H,Waseda K,et a1.Feasibility and safety of intracoronary nicorandil infusion as a novel hyperemic agent for fractional flow reserve measurements[J].Heart Vessels,2015,30(4):477-483.
[18]Guo S,Goetze JP,Jeppesen JL,et al.Effect of natriuretic peptides on cerebral artery blood flow in healthy volunteers[J].Peptides,2015,74(1):33-42.
[19]Araújo Júnior RF,Garcia VB,Leito RF,et al.Carvedilol imProves inflammatory response,oxidative stress and fibrosis in The alcohol-induced liver injury in rats by regulating kuppfer Cells and hepatic stellate cells[J].PLoS One,2016,11(2):E0148868-0148872.
[2]杨树森,甘润韬,孙延明,等.阿托伐他汀对ST段抬高型急性心肌梗死患者急诊PCI术后无复流现象的影响[J].临床心血管病杂志,2011,27(1):35-38.
[3]Arslan U,YamaN M,Kocao4lu,et al.Risk of no-reflow in culprit lesion versus culprit vessel PCI in acute STEMI[J].Coron Artery Dis,2015,26(6):510-515.
[4]祖秀光,刘素云,郝玉明,等.冠状动脉慢血流现象的临床意义[J].临床心血管病杂志,2007,23(12):900-902.
[5]牛君义,崔晓迎.影响急诊急性心肌梗死PCI术中慢血流和无复流相关因素分析[J].中华肿瘤防治杂志,2016,23(s2):165-166.
[6]Sun C,Zhi J,Bai X,et al.Comparison of the efficacy of recombinant human brain natriuretic peptide with saline hydration in preventing contrast-induced nephropathy in patients undergoing coronary angiography with or without concomitant percutaneous coronary intervention[J].Int J Clin Exp Med,2015,8(8):14166-14172.
[7]Hirohata A,Yamamoto K,Hirose E,et al.Nicorandil prevents microvascular dysfunction resulting from PCIin patients with stable angina pectoris:a randomised study.[J].EuroIntervention,2014,9(9):1050-1056.
[8]中华医学会心血管病学分会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(2):713-714.
[9]肖燕,杨丽娜,孙琴.氯吡格雷和替格瑞洛对急性ST段抬高型心肌梗死患者经皮冠状动脉介入术后TIMI分级及心功能影响的对比研究[J].实用心脑肺血管病杂志,2017,25(10):72-75.
[10]Wang XF,Ye M,Yan D,et al.Non-invasive ventilation improves hemorheology status in hypoxemic patients with acute myocardial infarction after PCI[J].J Geriatr Cardiol,2017,14(4):274-279.
[11]Liu WB,Zou ZP,Jiang HP,et al.Clinical significance of dynamic changes in hs-CRP and ADAMTS13levels in the blood serum of patients with no-reflow after PCI operation[J].Eur Rev Med Pharmacol Sci,2016,20(19):4148-4155.
[12]郇雷,刘红岩,亓华新,等.急诊PCI术后无复流STE-MI患者红细胞渗透脆性的变化[J].中国循证心血管医学杂志,2016,8(6):712-714.
[13]何伟民,黄景文,罗韶金,等.替格瑞洛联合比伐芦定对急性ST段抬高型心肌梗死患者急诊PCI术中无复流/慢血流的作用[J].血栓与止血学,2017,23(3):400-402.
[14]葛慧娟.重组人脑利钠肽对于急性心肌梗死后老年心力衰竭患者疗效及预后的影响[J].中国老年学,2016,36(3):602-604.
[15]Kawai Y,Hisamatsu K,Matsubara H,et al.Intravenous administration of nicorandil immediately before percutaneous coronary intervention can prevent slow coronary flow phenomenon[J].Eur Heart J,2009,30(7):765-772.
[16]杨倩倩,崔建国,王树娟,等.冠状动脉慢血流患者的影响因素分析[J].中国循环杂志,2017,32(9):877-881.
[17]Kato D,Takashima H,Waseda K,et a1.Feasibility and safety of intracoronary nicorandil infusion as a novel hyperemic agent for fractional flow reserve measurements[J].Heart Vessels,2015,30(4):477-483.
[18]Guo S,Goetze JP,Jeppesen JL,et al.Effect of natriuretic peptides on cerebral artery blood flow in healthy volunteers[J].Peptides,2015,74(1):33-42.
[19]Araújo Júnior RF,Garcia VB,Leito RF,et al.Carvedilol imProves inflammatory response,oxidative stress and fibrosis in The alcohol-induced liver injury in rats by regulating kuppfer Cells and hepatic stellate cells[J].PLoS One,2016,11(2):E0148868-0148872.
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |