急性心肌梗死溶栓治疗LPO和SOD的动态变化及临床意义

目的 :探讨急性心肌梗死 (AMI)患者尿激酶静脉溶栓前后氧自由基 (OFR)浓度的动态变化及其与再灌注损伤的关系。方法 :接受尿激酶静脉溶栓治疗的 38例AMI患者在溶栓前及溶栓后 2、 6、 12、 2 4h分别取血测定血清中脂质过氧化物 (LPO)、过氧化物歧化酶(SOD) ,依间接指标及溶栓后 90min冠状动脉造影结果 ,将患者分为再通组 ( 2 7例 )和未通组( 11例 ) ,比较两组患者血中上述指标的动态变化 ,并设正常对照组。结果 :AMI患者溶栓前血清LPO、SOD浓度均明显高于对照组 ,溶栓后再通组LPO浓度较溶栓前明显升高 ,SOD则于溶栓早期显著降低 ,6h后逐渐回升至溶栓前水平 ,未通组于溶栓前后无明显变化。结论 :AMI后OFR活性增高 ,早期溶栓再灌注加剧OFR代谢紊乱并导致心肌再灌注损伤 ,溶栓后LPO的异常增高可望成为临床判断血管再通的新指标

Dynamic observation and clinical mean of oxygen free radicals during thrombolytic therapy in patients with acute myocardial infarction

Objective:To observe serial changes of oxygen free radical activity and its relations to early reperfusion before and after intravenous thrombolytic therapy of urokinase in patients with acute myocardial infarction(AMI).Methods:The serum concentrations of lipid peroxide(LPO) and superoxide dismutase (SOD) were determined respectively in 38 cases with AMI before thrombolytic therapy and 2,6,12,24 hours after completion of the urokinase infusion.Thirty eight patients were divided into 2 groups according to indirect indices and coronary arteriography,27 with reperfusion group and 11 with non reperfusion.Concentrations of serum LPO and SOD were determined in each group respectively.Thirty five healthy individuals were served as controls.Results:The concentrations of serum LPO and SOD in AMI patients before thrombolytic therapy were significantly higher than that in the controls.With the patency of infarct related arteries in reperfusion group,LPO were increased and SOD decreased after thrombolytic therapy.There were no significant changes in non reperfusion group.Conclusion:OFR disturbance was closely related to acute myocardial ischemia and played an important role in myocardial reperfusion injury.