急性心肌梗死患者中性粒细胞氧化代谢改变及维生素C的干预作用

Polymorphonuclear leukocyte oxygen free radical production increased in patients with acute myocardial infarction and the suppressive effects of vitamin C

目的 评价急性心肌梗死 (AMI)患者中性粒细胞 (polymorphonuclear,PMN)氧化代谢功能以及维生素C的抗氧化损伤作用。方法 6 0例AMI患者被列入研究对象 ,随机分成两组 :Ⅰ组 (30例 ) :给予AMI的常规治疗 ;Ⅱ组 (30例 ) :在常规治疗的基础上加用维生素C静脉滴注 ,每天 3g ,连续应用 7d后停药。在入院后及治疗第 1,3,7,10天检测中性粒细胞化学发光 (polymorphonuclearchemiluminescence,PMN CL)参数 ,并行心电图检查 ,与AMI患者年龄、性别匹配的健康人 6 2例作为对照组 (Ⅲ组 )。结果 AMI患者PMN CL各项参数显著性高于健康对照组。在第 3,7d ,Ⅱ组其各项参数较Ⅰ组明显下降 ,在停用维生素C后 3d仍较Ⅰ组明显下降 (P分别 <0 .0 5 ,0 .0 1,0 .0 0 1) ,心电图ST段改善的积分明显高于Ⅰ组。结论 AMI患者中性粒细胞产生大量的氧自由基 ,造成机体氧化损伤 ;静脉滴注维生素C能有效抑制AMI患者中性粒细胞产生氧自由基 。

Objective To evaluate the role of polymorphonuclear(PMN) in patients with acute myocardial infarction (AMI). The preventive effects of Vitamin C-a potent free radical scavenger, on parameters of PMN oxygen free radicals (OFR) production in patients with AMI were also studied. Methods 60 patients with AMI were randomized to receive either conventional treatment only (group I, n =30), and plus vitamin C 3g once daily for 7 days, as group II ( n =30). Parameters of PMN OFR production were assayed by a method named as polymorphonuclear chemiluminescence (PMN CL) on the 1st,3rd,7 th and 10 th day after being hospitalized.62 healthy controls with similar age, sex were also studied (group III). Results Parameters of PMN CL increased significantly in patients with AMI compared with those in the healthy controls. Parameters of PMN CL decreased significantly in group II on the 3rd,7 th and 10 th day compared with those in group I ( P <0.05, 0.01, 0.001, respectively). ST segment score was significantly higher in group II than that in group I on the 3rd,7 th and 10 th day. Conclusions These results indicated that the PMN act as a potential contributor to extension of tissue injury induced by OFR. Supplementation with Vitamin C infusion might suppress PMN OFR production and could be beneficial in preventing myocardial necrosis.