维生素C对急性心肌梗死患者氧化代谢的影响

Supplementation with Vitamin C Suppresses Polymorphonuclear Leukocyte Oxygen Free Radical Production in Patients with Acute Myocardial Infarction

为评价抗氧化剂维生素 Ｃ对急性心肌梗死患者氧化代谢指标的影响，将３０ 例急性心肌梗死患者随机分成常规治疗组（１３ 例） 和维生素 Ｃ 治疗组（１７ 例） ，分别予以急性心肌梗死的常规治疗和在急性心肌梗死的常规治疗基础上加用维生素 Ｃ，每天２ 克，静脉滴注，共用７ 天。分别测定两组患者治疗前、治疗第３ 天及治疗第７ 天的中性粒细胞化学发光参数（ 峰值、积分和吞噬指数） 、血清肌酸磷酸激酶活性和血浆丙二醛浓度等氧化损伤指标，并测定血浆谷胱甘肽过氧化物酶和超氧化物歧化酶活性抗氧化损伤指标，同时观察心电图的动态演变。结果发现，在治疗第７ 天维生素 Ｃ治疗组的峰值、积分及吞噬指数较常规治疗组均明显下降（ Ｐ＜ ０ ．０５） ，而本底值在两组间及自身前后对比均无明显下降，血浆丙二醛浓度较常规治疗组也有明显下降（ Ｐ＜ ０ ．０５） 。在治疗第３ 天及第７ 天维生素 Ｃ 治疗组的血浆超氧化物歧化酶活性较常规治疗组均有明显上升（ Ｐ＜ ０ ．０１） ，血清肌酸磷酸激酶和血浆谷胱甘肽过氧化物酶活性较常规治疗组均无显著性差异，但两组在治疗第７ 天较治疗前的自身比较分别有明显下降或上升（ Ｐ＜ ０ ．０１） 。心电图监护发现，在治疗第７ 天维生素 Ｃ治疗组室性早搏?

Aim To evaluate the preventive effect of vitamin C ,a potent free radical scavenger, on the markers of polymorphonuclear leukocyte (PMN) oxygen free radical (OFR)production, lipid peroxidation and defenses against oxidative stress in patients with acute myocardial infarction (AMI). Methods 30 patients with AMI were randomized to receive either conventional treatment only (control group, n=13) or conventional treatment supplemented with vitamin C infusion (vitamin C group,n=17), 2 g per day, for 7 days. All measurements were performed before treatment, on the 3rd and 7th day after been hospitalized. The PMN OFR production was assayed by a convenient and sensitive method named as polymorphonuclear leukocyte chemiluminescence (PMN-CL). The plasma lipid peroxides concentration measured as malondialdehyde (MDA), activities of superoxide dismutase (SOD) and glutathione peroxidase (GSHPx) were estimated by chemical measurement. Meanwhile, serum CK activity and ECG were also monitored. Results Parameters of PMN-CL decreased significantly in vitamin C group on the 7th day compared with that in controls. Plasma MDA concentration decreased significantly on the 7th day and plasma activity of SOD increased more quickly on the 3rd and 7th day in vitamin C group than that in controls, however, it showed no salutary effects of vitamin C on CK and GSHPx activities in vitamin C group. Arrhythmia occurre less often in vitamin C group than in controls on the 7th day. Conclusions Supplementation with vitamin C may suppress PMN OFR production, decrease the levels of lipid peroxide, increase the plasma activity of antioxidative enzymatic system, and could be beneficial in preventing complications in such patients.