摘要
目的探讨小剂量促红细胞生成素治疗急性心肌梗死(acute myocardial infarction,AMI)患者的效果及其作用机制。方法选取杭州市第九人民医院心血管内科收治的116例AMI患者,依据治疗方式的不同分为试验组和对照组,每组各58例,对照组接受经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)手术及相关基础治疗措施的为对照组,试验组在此基础上同时给予小剂量促红细胞生成素(erythropoietin,EPO)治疗,对比两组患者PCI术后心肌灌注(thrombolysis in myocardial infarction,TIMI)分级、PCI术后即刻与术后不同时间肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine kinase-MB,CK-MB)、乳酸脱氢酶(lactate dehydrogenase,LDH)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST)、血清内皮细胞微粒(endothelial microparticle,EMPs)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)、内皮素(endothelin-1,ET-1)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、一氧化氮(nitric oxide,NO),术后12个月比较两组患者的不良心血管事件的发生率。结果试验组和对照组PCI术后的TIMI分级比较,差异无统计学意义(P>0.05);术后即刻,试验组和对照组的CK、CK-MB、LDH、AST比较,差异无统计学意义(P>0.05);术后48h,试验组的CK、CK-MB、LDH、AST均低于对照组(P<0.05);术后即刻,试验组和对照组的EMPs、MMP-9、ET-1、SOD、MDA、NO水平比较,差异无统计学意义(P>0.05);术后3d,试验组的EMPs、ET-1均低于对照组(P<0.05),SOD水平高于对照组(P<0.05);术后12个月,试验组的不良心血管事件发生率8.62%低于对照组的22.41%(P<0.05)。结论EPO联合基础疗法治疗AMI患者有利于减轻心肌损伤、减轻氧化应激对心肌造成的损伤,降低不良心血管事件的发生率。
Objective To explore the effect and mechanism of low-dose EPO in the treatment of acute myocardial infarction(AMI)patients.Methods A total of 116 AMI patients admitted to the Department of Emergency,Hangzhou Ninth People’s Hospital were retrospectively and randomly selected,and they were divided into an experimental group and a control group with 58 cases in each according to the different treatment methods,and received percutaneous coronary intervention(PCI)treatment and related basic treatment.The control group was PCI,and the experimental group was also given low-dose EPO treatment on this basis.The TIMI grades of myocardial perfusion after PCI between the two groups of patients,creatine kinase(CK),creatine kinase-MB(CK-MB),endothelial microparticle(EMPs),matrix metalloproteinase-9(MMP-9),endothelin-1(ET-1),superoxide dismutase(SOD),malondialdehyde(MDA),nitric oxide(NO)at 12 months after PCI and at different times after PCI The incidence of adverse cardiovascular events in the group were compared.Results There was no statistically significant difference in the TIMI grade between the experimental group and the control group after PCI(P>0.05);Immediately after the operation,there was no statistically significant difference in the levels of CK,CK-MB,LDH,AST between the experimental group and the control group(P>0.05);48h after operation,the measured values of CK,CK-MB,LDH,AST in the experimental group were lower than those in the control group(P<0.05);Immediately after the operation,there was no significant difference in EMPs,MMP-9,ET-1,SOD,MDA and NO levels(P>0.05);3 days after operation,the EMPs and ET-1 of the experimental group were lower than the control group(P<0.05),and the SOD level was higher than the control group(P<0.05);12 months after surgery,the incidence of adverse cardiovascular events in the test group was 8.62%,which was lower than 22.41%in the control group(P<0.05).Conclusion EPO combined with basic therapy in the treatment of AMI patients is beneficial to reduce myocardial damage,reduce the damage caused by oxidative stress to the heart and reduce the incidence of adverse cardiovascular events.
作者
秦永根
蔡立刚
董佳丽
贾瑞秀
QIN Yonggen;CAI Ligang;DONG Jiali;JIA Ruixiu(Department of Emergency,Hangzhou Ninth People’s Hospital,Hangzhou 311225,Zhejiang,China)
出处
《中国现代医生》
2023年第12期94-98,共5页
China Modern Doctor
