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人类心肌梗死急性期溶栓后血浆微量元素水平变化的时间进程。

Time-course of changes in plasma levels of trace elements after thrombolysis during the acute phase of myocardial infarction in humans.

作者信息

Pucheu S, Coudray C, Vanzetto G, Favier A, Machecourt J, de Leiris J

机构信息

Groupe de Physiopathologie Cellulaire Cardiaque, URA CNRS 1287, Université Joseph Fourier, Grenoble, France.

出版信息

Biol Trace Elem Res. 1995 Jan-Mar;47(1-3):171-82. doi: 10.1007/BF02790115.

Abstract

It has been suggested that the injury induced by reperfusion of the ischemic myocardium could result, in part, from the cytotoxic effects of oxygen free radicals. Since various trace elements are involved in several of the reactions leading to free radical production, we have measured plasma levels of copper, zinc, selenium, and iron: 1. In 18 patients (mean age 60 yr old) subjected to thrombolytic therapy within 6 h after the onset of a myocardial infarction (G1); 2. In 16 patients with coronary artery disease, but without a history of a previous myocardial infarction (MI) (mean age 50 yr old, G2); and 3. In 50 healthy volunteers divided into two subgroups according to age (mean age 33 yr old, G3 and 55 yr old, G4). Plasma myosin levels were used to estimate quantitatively the extent of the infarcted mass. Plasma trace element levels were measured in blood samples following centrifugation and storage at -80 degrees C. The main results were as followed: In G1 patients who have been subjected to thrombolysis, an important release of myosin was measured in plasma, with a peak at D6 (1678 vs 95 microU/L at H0). In those G1 patients after MI: 1. A significant increase in plasma copper levels was observed from day 4 to day 10 postinfarction (x1.15 in reference to the baseline data at H0); 2. A decrease in plasma zinc levels was observed and was maximum 12 h after the onset of the thrombolytic treatment; 3. A decrease in selenium concentration was observed in G1, as well as in G2 patients, compared to the control groups (80% of G3 and G4 values); and 4. A significant decrease in plasma iron levels was observed in G1 (67.8% of G3 and G4 control values) and was significant from H0 to day 7 (p < 0.01). In conclusion, this study underlined the time-course evolution of plasma trace element levels in the followup of patients who have been subjected to thrombolysis following a MI and the potential prognostic implication of such variations.

摘要

有人提出,缺血心肌再灌注所导致的损伤可能部分源于氧自由基的细胞毒性作用。由于多种微量元素参与了导致自由基产生的若干反应,我们测定了血浆中铜、锌、硒和铁的水平:1. 18例患者(平均年龄60岁)在心肌梗死发作后6小时内接受溶栓治疗(G1组);2. 16例冠心病患者,但无既往心肌梗死病史(平均年龄50岁,G2组);3. 50名健康志愿者,根据年龄分为两个亚组(平均年龄33岁,G3组;平均年龄55岁,G4组)。血浆肌球蛋白水平用于定量评估梗死心肌的范围。血浆微量元素水平在血液样本经离心并在-80℃储存后进行测定。主要结果如下:在接受溶栓治疗的G1组患者中,血浆中检测到肌球蛋白大量释放,在第6天达到峰值(第0小时时为95微单位/升,第6天为1678微单位/升)。在那些心肌梗死后的G1组患者中:1. 梗死发作后第4天至第10天,血浆铜水平显著升高(相对于第0小时的基线数据升高1.15倍);2. 观察到血浆锌水平下降,且在溶栓治疗开始后12小时降至最低;3. 与对照组相比,G1组以及G2组患者的硒浓度均下降(为G3组和G4组值的80%);4. G1组血浆铁水平显著下降(为G3组和G4组对照值的67.8%),且从第0小时至第7天差异显著(p<0.01)。总之,本研究强调了心肌梗死后接受溶栓治疗患者随访过程中血浆微量元素水平的时间进程演变以及这种变化潜在的预后意义。

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