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丹参多酚酸盐在急性心肌梗死患者经皮冠状动脉介入治疗围手术期对氧化应激及血浆鸢尾素/肾上腺髓质素2的影响

Perioperative application of salvianolate on oxidative stress and plasma IMD/ADM2 in patients with acute myocardial infarction undergoing PCI.

作者信息

Zhang Qiang, Jiao Fengjun, Hua Chongjun

机构信息

Department of Internal Medicine, Dezhou People's Hospital, Dezhou, Shandong 253014, P.R. China.

Department of Cardiovascular Medicine, The First People's Hospital of Xianyang, Xianyang, Shaanxi 712000, P.R. China.

出版信息

Exp Ther Med. 2017 Apr;13(4):1475-1479. doi: 10.3892/etm.2017.4114. Epub 2017 Feb 10.

Abstract

The present study was conducted to investigate the effects of salvianolate on perioperative oxidative stress and plasma Intermedin/adrenomedullin 2 (IMD/ADM2) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). The clinical data of 108 patients with AMI treated by PCI were retrospectively analyzed. According to the use of salvianolate in perioperative period, the patients were divided into the study group (n=62) and the control group (n=46). The control group was given routine treatment while the study group was given routine treatment combined with intravenous infusion of salvianolate (200 mg administered once at 24 h before operation, once/day after operation, 1 week later, the curative effect was observed). The changes in levels of hemodynamic indexes [fibrinogen (FIB), platelet aggregation rate (PAG), plasma viscosity, packed-cell volume (PCV)], oxidative stress indexes [superoxide dismutase (SOD), glutathione peroxidase (GSH Px)], cardiac function indexes [left ventricular ejection fraction (LVEF), cardiac output (CO)], related biochemical indexes [high-sensitivity C-reactive protein (hs-CRP), N-terminal pro brain natriuretic peptide (NT proBNP)] and plasma IMD/ADM2 in the two groups at 24 h pre-operation and the 8th day postoperation were analyzed. On the 8th day post-operation, hemodynamic indexes such as FIB (3.3±1.0 and 3.9±0.9) g/l, PAG (20.6±6.5 and 41.6±7.7)%, plasma viscosity (1.1±0.5 and 1.7±0.6) mPa•s/120 s and PCV (40.0±3.8 and 45.5±3.7)%, the related biochemical indexes such as hs-CRP (55.1±4.8 and 79.3±5.3) mg/l and NT-proBNP (435.6±305.2 and 788.6±310.8) ng/l in the two groups were significantly decreased compared to those pre-operation; the differences were statistically significant (P<0.05). The oxidative stress indexes such as SOD (43.6±1.9 and 24.2±2.0) U/ml and GSH-Px (822.6±13.52 and 742.6±62.6) enzyme activity unit, the cardiac function indexes such as LVEF (45.1±3.5 and 41.9±3.3)% and CO (4.6±0.5 and 4.1±0.5) l/min and plasma IMD/ADM2 (163.5±20.2 and 144.2±22.5) pg/ml in the two groups were significantly increased compared to those pre-operation; the differences were statistically significant (P<0.05). In conclusion, applying intravenous infusion of salvianolate in patients with AMI during perioperative period of PCI can effectively improve the oxidative stress reaction and have positive effects on regulating plasma IMD/ADM2 level, which promoted cardiac function recovery and enhances myocardial perfusion volume.

摘要

本研究旨在探讨丹参多酚酸盐对行经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者围手术期氧化应激及血浆中介素/肾上腺髓质素2(IMD/ADM2)的影响。回顾性分析108例行PCI治疗的AMI患者的临床资料。根据围手术期是否使用丹参多酚酸盐,将患者分为研究组(n = 62)和对照组(n = 46)。对照组给予常规治疗,研究组在常规治疗基础上联合静脉输注丹参多酚酸盐(术前24 h给药1次,剂量为200 mg,术后每天1次,1周后观察疗效)。分析两组患者术前24 h及术后第8天血流动力学指标[纤维蛋白原(FIB)、血小板聚集率(PAG)、血浆黏度、红细胞压积(PCV)]、氧化应激指标[超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH Px)]、心功能指标[左心室射血分数(LVEF)、心输出量(CO)]、相关生化指标[高敏C反应蛋白(hs-CRP)、N末端脑钠肽前体(NT proBNP)]及血浆IMD/ADM2的变化。术后第8天,两组患者的FIB(3.3±1.0和3.9±0.9)g/l、PAG(20.6±6.5和41.6±7.7)%、血浆黏度(1.1±0.5和1.7±0.6)mPa•s/120 s及PCV(40.0±3.8和45.5±3.7)%等血流动力学指标,以及hs-CRP(55.1±4.8和79.3±5.3)mg/l、NT-proBNP(435.6±305.2和

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