还原型谷胱甘肽对急性心肌梗死再灌注的疗效观察

目的观察还原型谷胱甘肽(GSH)对急性心肌梗死(AMI)急诊冠状动脉内干预(PCI)后再灌注心肌的保护作用。方法对符合入选标准的58例患者,于发病12h内行急诊PCI,再通后即刻行SPECT检查,并随机分为两组,对照组患者(28例)采用常规治疗(低分子肝素、阿司匹林、波立维、硝酸甘油等);GSH组患者(30例)在常规治疗基础上加用GSH静滴(血运重建即刻静滴GSH2400mg,2h内滴完,1次/d,持续15d),15d后复查SPECT。结果两组患者的心肌灌注缺损积分、左室射血分数(LVEF)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)间差别均有显著性意义(P<0.05)。结论GSH对AMI急诊PCI后再灌注心肌有良好的保护作用。

The Observation of Effects of Reduced Glutathione(GSH) in Improving Myocardium Reperfusion in Acute Myocardial Infarction

Objective To evaluate the effect of Reduced Glutathione(GSH) in improving myocardium reperfusion in patients with acute myocardial infarction(AMI) after the emergency percutaneous coronary intervention(PCI) by 99mTc-tetrofosmin(P53) myocardium reperfusion temography (SPECT).Methods Fifty-eight patients with a first AMI shortly after PCI were randomly divided into the GSH group(n=30) and the control group(n=28).In GSH group,patients were treated routinely (Low weight heparin,Aspirin,Boliwei,Nitroglcerine and so on) plus GSH and the control group with routine treatment only.The SPECT was performed simultaneously and 15 days after PCI on all patients.Results (1)No significant difference of baseline clinical characteristics was found between the two groups before or shortly after PCI.(2)The ischemic myocardial area of the GSH group were significantly lower than that in the control group fifteen days after PCI.(3)Compared with the control group,the LVEF (left ventricular ejection fraction),LVEDV(left ventricular end-diastolic volume) and LVESV(left ventricular end-systolic volume) of the GSH group were more improved fifteen days after PCI.Conclusion Introvenous administration of GSH shortly after PCI can improve myocardial reperfusion,leading to better functional outcome than with PCI alone.