【www.zhangdahai.com--安全生产公文】
[摘要] 目的:胺碘酮(AM)对急性心肌梗死(AMI)溶栓术后丙二醛(MDA)、超氧化物歧化酶(SOD)的影响。方法:将80例溶栓AMI患者随机分为A组(AM组,40例)和B组(常规组,40例),观察两组患者成功溶栓后SOD、MDA变化。结果:溶栓术后A组MDA含量较B组明显降低,SOD活性明显增高(P0.05),见表1。综合两组患者情况,胸痛明显缓解、ST段下降程度超过溶栓前1/2及再灌注心律失常情况(室早、室速、室颤、加速性室性自主心律等)恢复正常,所选患者均显示溶栓成功。
2.2 AM对AMI溶栓术后MDA、SOD的影响
两组均在溶栓后2 h抽血,应用硫代巴比妥酸比色法(TBA)测定血清MDA含量及黄嘌呤氧化法测定血清SOD活性。A组MDA含量为(6.42±0.57) μmol/L,而B组MDA含量明显升高,为(9.38±0.59) μmol/L;SOD活性结果正好相反,A组为(106.73±9.24) U/ml,B组为(72.32±6.58) U/ml, A组与B组相比,差异有统计学意义(P 本试验应用AM对AMI溶栓前干预,结果降低血清MDA含量及增加血清SOD活性,说明AM对心肌I/RI有抗氧化保护作用。由于临床患者过少,且仅用MDA含量及SOD活性反映AM对心肌I/RI有抗氧化保护作用,故本试验有一定的局限性,但在AM临床应用上有一定的指导意义。
[参考文献]
[1]中华医学会心血管病学分会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志, 2001, 29 (12):710.
[2]Lapenna D,Ciofani G,Pierdomenico SD,et al. Amiodarone inhibits tocopherol-mediated human lipoprotein peroxidation[J].Biochemical Pharmacology,2007,74(2):265-272.
[3]Halici Z,Dengiz GO,Odabasoglu F, et al.Amiodarone has anti-inflammatory and anti-oxidative properties: an experimental study in rats with carrageenan-induced paw edema[J].European Journal of Pharmacology,2007,566(1/3):215-221.
[4]Hiroyuki T, Masafumi K, Tomohiro A,et al.Targeting of ischemic/reperfused myocardium by liposomal amiodarone reduced ventricular fibillilation in rats[J].Circulation,2009,120: S631.
[5]Celestino D,Medei E,Moro S,et al.Acute in vitro effects of dronedarone,an iodine-free derivative,and amiodarone,on the rabbit sinoatrial node automaticity: a comparative study[J]. Journal of Cardiovascular Pharmacology and Therapeutics,2007,12(3):248-257.
[6] Yuehui Y,Darshan D,Zengchang L,et al.Prospective randomized study comparing amiodarone vs. amiodarone plus losartan vs. amiodarone plus perindopril for the prevention of atrial fibrillation recurrence in patients with lone paroxysmal atrial fibrillation[J].European Heart Journal,2006,27(15):1841-1846.
[7]Kolettis TM,Agelaki MG,Baltogiannis GG,et al.Comparative effects of acute vs. chronic oral amiodarone treatment during acute myocardial infarction in rats[J].Europace, 2007,(9):1099-1104.
[8]Sheba A,Michiel R,Harry J,et al.Investigators continuous vs episodic prophylactic treatment with amiodarone for the prevention of atrial fibrillation:a randomized trial[J].JAMA,2008, 300(15):1784-1792.
[9]Patricia V,Richard G.Prescribing amiodarone:an evidence-based review of clinical indications[J].JAMA,2007,298(11):1312-1322.
[10]Hitoshi T,Makoto K.Amiodarone improves cardiac sympathetic nerve function to hold norepinephrine in the heart,prevents left ventricular remodeling,and improves cardiac function in rat dilated cardiomyopathy[J].Circulation,2005,111(7): 894-899.
(收稿日期:2010-01-04)
