依达拉奉注射液对心肌缺血再灌注损伤的保护作用

目的：探讨脑保护剂依达拉奉注射液的药物后处理是否对急性心肌缺血溶栓后再灌注损伤有保护作用。方法：选取2009年12月-2013年12月本院收治的有溶栓适应证且行静脉内选择性尿激酶溶栓治疗的160例急性心肌梗死患者，按照随机数字表法分为观察组82例和对照组78例。观察组在溶栓前以及治疗后给予依达拉奉注射液30 mg加0.9%氯化钠溶液100 mL静脉滴注，2次/d，共14 d。对照组用等量安慰药静脉滴注。所有患者进行心电及血流动力学监测，观察比较ST段再抬高、再灌注心律失常及梗死后心绞痛的发生情况。冠脉CT测定血管再通情况及4周病死率。结果：观察组患者的ST段再抬高、再灌注心律失常及梗死后心绞痛发生率均明显低于对照组，且血管再通率65.9%明显高于对照组的48.7%，4周病死率12.2%明显低于对照组的23.1%，差异均有统计学意义（P〈0.01）。两组在室性早搏、窦性阻滞方面比较差异无统计学意义（P〉0.05）；而在加速性室性自主心律、室性心动过速和心室颤动等方面比较差异均有统计学意义（P〈0.01）。结论：对于急性缺血的心肌，在再灌注前注射依达拉奉注射液进行药物后处理可减轻心肌缺血再灌注损伤，有效清除氧自由基，提高机体抗氧化应激的能力。溶栓前以及治疗后给药对急性缺血性心肌的保护效果显著，依达拉奉注射液可能是一种新的心血管临床药物。

The Protective Effect of Edaravone Injection on Myocardial Ischemia Reperfusion Injury

Objective： To investigate the drug brain protective agent Edaravone Injection after drug treatment whether has a protective effect on acute myocardial ischemia reperfusion injury after thrombolysis.Method：160 patients with acute myocardial infarction who had thrombolysis indication and selective thrombolytic therapy with urokinase intravenous in our hospital from December 2009 to December 2013 were selected,they were randomly divided into the observation group for 82 cases and the control group for 78 cases according to the random number table method.The observation group before and after thrombolytic therapy was given Edaravone Injection 30 mg plus 0.9%Sodium Chloride Solution intravenous infusion of 100 mL,bid,for 14 d.The control group was given the same amount of placebo by intravenous infusion.The ECG and hemodynamic monitoring of all patients were detected.Result：The incidence of ST segment re-elevation,reperfusion arrhythmia and postinfarction angina pectoris in the observation group were significantly lower than those in the control group,the recanalization rate of the observation group was 65.9%,it was significantly higher than the 48.7% of the control group,the mortality for 4 weeks of the observation group was 12.2%,it was significantly lower than the 23.1%of the control group,the differences were statistically significant（P〈0.01）.There were no statistically significant differences in premature ventricualr contraction and sinus arrest between the groups（P〉0.05）, but in accelerated idioventricular rhythm,ventricular tachycardia and ventricular fibrillation heartbeat,the differences were statistically significant（P〈0.01）.Conclusion：In acute myocardial ischemia,injection with Edaravone Injection after drug treatment before reperfusion can alleviate myocardial ischemia reperfusion injury,effectively clear oxygen free radical,improve the ability of antioxidative stress.Thrombolytic therapy before and after treatment administration on acute ischemic myocardial protection effect is o