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阿托伐他汀预处理对行直接经皮冠状动脉介入治疗患者的保护作用与氧自由基水平降低有关。

Protection by atorvastatin pretreatment in patients undergoing primary percutaneous coronary intervention is associated with the lower levels of oxygen free radicals.

机构信息

Department of Cardiology, Beijing Friendship Hospital, the Capital Medical University, Beijing, China.

出版信息

J Cardiovasc Pharmacol. 2013 Sep;62(3):320-4. doi: 10.1097/FJC.0b013e31829be05b.

DOI:10.1097/FJC.0b013e31829be05b
PMID:23714773
Abstract

OBJECTIVES

The aims of this study were to investigate the effects of atorvastatin pretreatment on the oxygen free radicals and its protective role on the myocardial cell during the ischemic reperfusion injury.

METHODS

One hundred fifty-six patients with ST elevation myocardial infarction undergoing percutaneous coronary interventions, aged from 29 to 85 years, were selected. Eighty patients were randomly assigned to placebo group and 76 to statin treatment (80-mg loading dose given a mean of 1.5 hours before percutaneous coronary intervention). The nitrogen monoxidum, malondialdehyde, and superoxide dismutase (SOD) were assayed before and after reperfusion. Thrombolysis in myocardial infarction (TIMI) grade and corrected TIMI frame count were measured after reperfusion. The creatine kinase-MB and troponin T peak levels after myocardial infarction were recorded.

RESULTS

There was no significant difference in the nitrogen monoxidum, malondialdehyde, and SOD levels (P > 0.05) between the 2 groups before intervention. After the reperfusion, significantly lower creatine kinase-MB (289.9 ± 180.8 U/L vs. 360.5 ± 206.4 U/L, P = 0.025) and troponin T (4.60 ± 3.13 ng/mL vs. 6.01 ± 4.98 ng/mL, P = 0.035) peak levels can be observed in the statin versus the placebo group, and the SOD level of the statin group is higher than that of the placebo group (34.14 ± 15.07 U/mL vs. 29.06 ± 12.76 U/mL, P = 0.024).

CONCLUSIONS

Atorvastatin can reduce oxygen free radicals developed in reperfusion, imposing protective effect on the myocardial cell during ischemic reperfusion injury.

摘要

目的

本研究旨在探讨阿托伐他汀预处理对缺血再灌注损伤时氧自由基的影响及其对心肌细胞的保护作用。

方法

选择 156 例年龄 29~85 岁的 ST 段抬高型心肌梗死患者行经皮冠状动脉介入治疗。将患者随机分为安慰剂组 80 例和他汀治疗组 76 例(在经皮冠状动脉介入治疗前 1.5 小时给予 80mg 负荷剂量)。测定再灌注前后的一氧化氮、丙二醛和超氧化物歧化酶。再灌注后测定心肌梗死溶栓治疗(TIMI)分级和校正 TIMI 帧数。记录心肌梗死后肌酸激酶同工酶-MB 和肌钙蛋白 T 峰值水平。

结果

干预前两组的一氧化氮、丙二醛和超氧化物歧化酶水平无显著差异(P>0.05)。再灌注后,他汀组肌酸激酶同工酶-MB(289.9±180.8 U/L 比 360.5±206.4 U/L,P=0.025)和肌钙蛋白 T(4.60±3.13 ng/mL 比 6.01±4.98 ng/mL,P=0.035)峰值水平明显降低,且他汀组的超氧化物歧化酶水平高于安慰剂组(34.14±15.07 U/mL 比 29.06±12.76 U/mL,P=0.024)。

结论

阿托伐他汀可减少再灌注时产生的氧自由基,对缺血再灌注损伤心肌细胞发挥保护作用。

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