陈淼,李虹伟,王永亮,陈晖,沈潞华

• 1:首都医科大学附属北京友谊医院心血管中心

摘要(Abstract)：

目的探讨阿托伐他汀对再灌注损伤中氧自由基的影响及其对细胞的保护作用。方法选取行急诊经皮冠状动脉介入治疗(PCI)的ST段抬高性心肌梗死患者共85例,年龄29~85岁,随机分为对照组49例,服药组36例(再灌注前给予立普妥80 mg口服),血管再通前后测定一氧化氮(NO)、丙二醛(MDA)、过氧化物歧化酶(SOD)、血脂、ST段抬高指数,TIMI分级及校正的TIMI血流帧数(CTFC),并记录肌酸激酶MB型同工酶(CK-MB)、肌钙蛋白(Tn)T的峰值和达峰时间。结果对照组及服药组基线指标(包括年龄、性别、发病时间、心功能等)差异均无统计学意义(P>0.05),术前NO、MDA、SOD血脂、ST段抬高指数(STI)、梗死相关血管差异亦均无统计学意义(P>0.05)。术后与对照组相比,服药组的CK-MB峰值降低,差异有统计学意义(253.24±35.21 U/L比361.30±26.31 U/L,P=0.040);术后2 h服药组的SOD较对照组水平升高(40.10±2.15 U/mL比36.05±6.97 U/mL,P=0.037)。结论急诊PCI前短期应用阿托伐他汀可以减少再灌注损伤时产生的氧自由基,从而起到保护心肌细胞的作用。

关键词(KeyWords)： 心肌再灌注损伤;活性氧;阿托伐他汀

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈淼,李虹伟,王永亮,陈晖,沈潞华

参考文献(References)：

• [1]Santoro GM,Valenti R,Buonamici P,et al.Relation between STsegment changes and myocardial perfusion evaluated by myocardi-al contrast echocardiography in patients with acute myocardial in-farction treated with direct angioplasty.Am J Cardiol,1998,82:932-937.
• [2]Ruiz-Ginés JA,López-Ongil S,González-Rubio M,et al.Reac-tive oxygen s pecies induce proliferation of bovine aortic endothe-lial cells.J Cardiovasc Pharmacol,2000,35:109-113.
• [3]Wassmann S,Laufs U,Muller K,et al.Cellular antioxidanteffects of atorvastatin in vitro and in vivo.Arterioscler ThrombVasc Biol,2002,22:300-305.
• [4]高春恒,张平洋,朱向明,等.辛伐他汀对SHR心肌组织SOD、MDA、NOS、NO及心肌间质胶原含量的影响.高血压杂志,2004,12:537-541.
• [5]Suzumura N,Yasuhara M,Tanaka K,et al.An in vitro study ofthe hydroxyl radical scavenging property of fluvastatin and HMGCoA reductase inhibitor.ChemPharmBull,1999,47:1010-1012.
• [6]Fenster BE,Tsao PS.Endothelial dysfunction:clinical strategiesfor treating oxidant stress.Am Heart J,2003,146:218-226.
• [7]Pasceri V,Patti G,Nusca A,et al.Randomized trial of atorvas-tatin for reduction of myocardial damage during coronary interven-tion.Circulation,2004,110:674-678.
• [8]Patti G,Pasceri V,Colonna G,et al.Atorvastatin pretreatmentimproves outcomes in patients with acute coronary syndromes un-dergoing early percutaneous coronary intervention.J Am CollCardiol,2007,49:1272-1278.
• [9]Zhao JL,Yang YJ,Gao RL.Pretreatment with simvastatin re-duces myocardial no-reflowby opening mitochondrial KATP chan-nel.British J Pharmacol,2006,149:243-249.