脂质微球 1 对心绞痛患者择期经皮冠状动脉介入治疗后心肌损伤的保护作用：一项初步研究。

Protective effect of lipid microspheres 1 on myocardial injury following elective percutaneous coronary intervention in patients with angina pectoris: a pilot study.

机构信息

Department of Cardiology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

J Cardiovasc Med (Hagerstown). 2011 Nov;12(11):790-4. doi: 10.2459/JCM.0b013e32834bb47c.

DOI:10.2459/JCM.0b013e32834bb47c

PMID:21934521

Abstract

BACKGROUND

Prostaglandin E1 incorporated into lipid microspheres (lipo-PGE1) is effective in the treatment of peripheral vascular disorders and diabetic neuropathy. It is unknown whether it has protective effects in patients with angina pectoris undergoing percutaneous coronary intervention (PCI).

OBJECTIVES

The goal of this pilot study was to investigate whether lipo-PGE1 has protective effects in patients with angina pectoris undergoing PCI.

METHODS

A single-blinded, randomized controlled trial was conducted in 79 patients with stable or unstable angina pectoris. The control group received standard medical therapy, and the Lipo-PGE1 group (n = 40) received 20 μg/day of lipo-PGE1 intravenously, starting at least 48 h before PCI and continuing for 5 days. Cardiac troponin T (cTnT) and creatine kinase myocardial isoenzyme (CK-MB) were measured before lipo-PGE1 infusion and at 6, 12 and 24 h after PCI.

RESULTS

The cTnT and CK-MB concentrations were lower in the lipo-PGE1 group than in the control group at 6 h (0.15 ± 0.33 vs. 0.43 ± 0.77; 2.87 ± 3.99 vs. 5.64 ± 6.27, respectively; P < 0.05), 12 h (0.20 ± 0.48 vs. 0.54 ± 0.85; 3.58 ± 5.22 vs. 7.45 ± 9.48; P < 0.05) and 24 h (0.18 ± 0.50 vs. 0.50 ± 0.75; 3.15 ± 4.50 vs. 6.16 ± 6.83; P < 0.05). The incidence of postprocedural myocardial injury, defined as an elevation of cTnT more than 0.1 ng/ml or CK-MB more than 5.0 ng/ml, was less in the PGE1 group than in the control group (30 vs. 54%; 13 vs. 31%, respectively; P < 0.05). Lipo-PGE1 was well tolerated and there were no serious adverse events or side-effects.

CONCLUSIONS

Lipo-PGE1 treatment appears to reduce myocardial injury following elective PCI in angina patients.

摘要

背景

前列腺素 E1 包入微脂粒（脂微球前列腺素 E1，lipo-PGE1）治疗外周血管疾病和糖尿病性神经病有效。尚不清楚其在经皮冠状动脉介入治疗（PCI）的心绞痛患者中是否具有保护作用。

目的

本研究旨在探讨脂微球前列腺素 E1 是否对行 PCI 的心绞痛患者具有保护作用。

方法

本单盲、随机对照试验纳入 79 例稳定型或不稳定型心绞痛患者。对照组接受标准药物治疗，脂微球前列腺素 E1 组（n=40）则在 PCI 前至少 48 h 开始每天静脉内给予 20 μg 脂微球前列腺素 E1，持续 5 天。在脂微球前列腺素 E1 输注前及 PCI 后 6、12 和 24 h 测定心肌肌钙蛋白 T（cTnT）和肌酸激酶同工酶（CK-MB）。

结果

与对照组相比，脂微球前列腺素 E1 组在 PCI 后 6 h（0.15±0.33 比 0.43±0.77；2.87±3.99 比 5.64±6.27；P<0.05）、12 h（0.20±0.48 比 0.54±0.85；3.58±5.22 比 7.45±9.48；P<0.05）和 24 h（0.18±0.50 比 0.50±0.75；3.15±4.50 比 6.16±6.83；P<0.05）时 cTnT 和 CK-MB 浓度更低。脂微球前列腺素 E1 组术后心肌损伤（定义为 cTnT 升高超过 0.1 ng/ml 或 CK-MB 超过 5.0 ng/ml）的发生率低于对照组（30%比 54%；13%比 31%；P<0.05）。脂微球前列腺素 E1 耐受性良好，无严重不良事件或副作用。