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目的 :探讨急性心肌梗死 (AMI)患者尿激酶静脉溶栓前后氧自由基 (OFR)浓度的动态变化及其与再灌注损伤的关系。方法 :接受尿激酶静脉溶栓治疗的 38例AMI患者在溶栓前及溶栓后 2、 6、 12、 2 4h分别取血测定血清中脂质过氧化物 (LPO)、过氧化物歧化酶(SOD) ,依间接指标及溶栓后 90min冠状动脉造影结果 ,将患者分为再通组 ( 2 7例 )和未通组( 11例 ) ,比较两组患者血中上述指标的动态变化 ,并设正常对照组。结果 :AMI患者溶栓前血清LPO、SOD浓度均明显高于对照组 ,溶栓后再通组LPO浓度较溶栓前明显升高 ,SOD则于溶栓早期显著降低 ,6h后逐渐回升至溶栓前水平 ,未通组于溶栓前后无明显变化。结论 :AMI后OFR活性增高 ,早期溶栓再灌注加剧OFR代谢紊乱并导致心肌再灌注损伤 ,溶栓后LPO的异常增高可望成为临床判断血管再通的新指标
Objective: To investigate the dynamic change of oxygen free radical (OFR) concentration in acute myocardial infarction (AMI) patients before and after intravenous thrombolysis of urokinase and its relationship with reperfusion injury. Methods: Thirty-eight AMI patients undergoing urokinase thrombolysis before and after thrombolysis at 2, 6, 12, and 24 hours, respectively. Serum levels of lipid peroxide (LPO), superoxide dismutase (SOD). According to indirect indicators and coronary angiography at 90 minutes after thrombolytic therapy, the patients were divided into two groups: recanalization group (n = 27) and unreasonable group (n = 11) And set the normal control group. Results: The levels of LPO and SOD in patients with AMI before thrombolysis were significantly higher than those in the control group. After thrombolysis, the LPO concentration in thrombolysis group was significantly higher than that before thrombolysis, and SOD was significantly decreased in early thrombolysis, Pre-suppository level, did not pass before and after thrombolysis group no significant change. CONCLUSION: OFR activity is increased after AMI. Early thrombolysis and reperfusion exacerbate OFR metabolism and lead to myocardial reperfusion injury. The abnormal increase of LPO after thrombolysis is expected to become a new indicator of vascular recanalization