磷酸肌酸钠对急性冠状动脉综合征患者经皮冠状动脉介入术后心肌的保护作用

目的近年来,经皮冠状动脉介入术(percutaneous coronary intervention,PCI)广泛应用于临床,如何有效减轻心肌再灌注损伤是一项需要解决的问题。文中旨在观察磷酸肌酸钠(creatine phosphate,CrP)对急性冠状动脉综合征(acute cor-onary syndrome,ACS)患者PCI术后的心肌保护作用。方法 180例ACS患者成功行PCI术后随机分为治疗组90例男53例、女37例,平均年龄(63.6±12.4)岁]和对照组90例男56例、女34例,平均年龄(65.3±12.6)岁]。对照组于PCI术前、术后只给予ACS常规药物治疗,治疗组在常规药物治疗基础上于PCI术后静脉应用CrP治疗5 d。监测所有患者术前及术后血清中磷酸肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、肌钙蛋白T(troporin T,cTnT)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdenyde,MDA)及一氧化氮(nitric oxide,NO)含量变化。结果治疗组术后血清中SOD含量明显高于对照组41.2(10.3～168.2)pg/ml vs 32.4(10.5～96.8)pg/ml,P<0.01)];而血清MDA、LDH、CK-MB含量均明显低于对照组3.22(1.00～7.84)pg/ml vs 3.67(0.58～9.82)pg/ml;156.2(84.0～703.5)U/L vs 176.5(94.0～983.7)U/L;11.0(5.0～104.0)U/L vs 14.5(5.0～196.5)U/L,P<0.01)];2组术后血清中cTnT及NO含量变化无明显差异1.25(0.01～8.5)ng/ml vs 1.37(0.01～9.2)ng/ml;165.5(22.5～437.7)μmol/L vs159.6(20.3～414.4)μmol/L,P>0.05)]。结论 CrP对ACS患者PCI术后心肌具有一定保护作用。

Creatine phosphate protects the myocardium of acute coronary syndrome patients after percutaneous coronary intervention

Objective Percutaneous coronary intervention(PCI) has been applied widely in clinical practice for several years.How to effectively reduce myocardial reperfusion injury is one of the issues to be addressed.The authors observed the myocardium protecting effect of creatine phosphate(CrP) in patients with acute coronary syndrome(ACS) after PCI.Methods A total of 180 ACS patients treated by PCI were equally randomly into a control group 56 males,34 females and aged(65.3±12.6)yr] and a treatment group 53 males,37 females and aged(63.6±12.4)yr],the former given conventional medication before and after PCI,while the latter intravenous injection of CrP for 5 days after PCI in addition to conventional medication.We detected the levels of CK-MB,LDH,cTnT,SOD,MDA and NO in the serum of all the patients before and after PCI.Results The treatment group showed a significantly higher level of serum SOD 41.2(10.3-168.2)pg/ml and remarkably lower levels of serum MDA,LDH and CK-MB 3.22(1.00-7.84)pg/ml],156.2(84.0-703.5)U/L and 11.0(5.0-104.0)U/L] than the control group 32.4(10.5-96.8)pg/ml,3.67(0.58-9.82)pg/ml];176.5(94.0-983.7)U/L and 14.5(5.0-196.5)U/L,P<0.01].There were no statistically significant differences between the two groups in the levels of cTnT and NO 1.25(0.01-8.5)ng/ml vs 1.37(0.01-9.2)ng/ml and 165.5(22.5-437.7)umol/L vs 159.6(20.3-414.4)umol/L,P>0.05].Conclusion CrP could protect the myocardium of ACS patients after PCI.