冠状动脉介入治疗后心肌再灌注损伤与冠状动脉侧支循环关系的探讨

目的 :探讨冠心病患者经皮冠状动脉介入治疗 (PCI)前后血丙二醛 (MDA)、超氧化物歧化酶 (SOD)及左心室功能的变化及其与冠状动脉侧支循环的关系。方法 :选择接受PCI的 75例冠心病患者 ,根据冠状动脉造影结果分为无侧支循环组 (4 4例 )和侧支循环组 (31例 ) ,在术前及术后分别测定静脉血MDA、SOD水平 ,用超声心动图测定左心室射血分数(LVEF)及Tei指数。结果 :两组术后 2h静脉血MDA升高、SOD降低 (均P <0 .0 1) ,术后 2 4h无侧支循环组MDA回降、SOD上升 ,与术前比较仍有显著性差异 (P <0 .0 1) ;两组间PCI后MDA、SOD及Tei指数有显著性差异 (P <0 .0 5 ,P <0 0 1)。结论 :冠状动脉侧支循环能减轻冠心病患者PCI治疗后的心肌再灌注损伤。

A study on the relationship between coronary artery collateral circulation and myocardial reperfusion injury after percutaneous coronary intervention

Objective:To investigate the relationship between coronary artery collateral circulation and myocardial reperfusion injury after percutaneous coronary intervention (PCI).Methods:75 patients with coronary artery disease were divided into patients without collateral group (n=44) and patients with collateral group (n=31) according to the results of coronary angiography. Malondialdehyde (MDA) and superoxide dismutase (SOD) were measured before and 2 hours and 24 hours after PCI. And cardiac: function were detected before and 24 hours after PCI with two dimension and Doppler echocardiography.Results:MDA was increased and SOD decreased 2 hours after PCI in all patients (both P<0.01) and MDA was increased and SOD decreased 24 hours after PCI in patients without collateral group (P<0.01).There were significant differences between two groups in serum MDA,SOD,and Tei index after PCI(P<0.05,P<0.01).Conclusion:Coronary artery collateral circulation might abate myocardial reperfusion injury in patients with coronary artery disease after PCI.