乌司他丁对急性心肌梗死患者溶栓治疗后血清炎症介质的影响

Effect of ulinastatin on the expression of serum inflammatory mediators in patients with acute myocardial infarction(AMI) after thrombolysis

目的探讨乌司他丁对急性心肌梗死(AMI)患者溶栓后血清炎症介质表达水平的影响。方法选取2017年1~12月我院收治的AMI患者84例,随机分为对照组和试验组,每组各42例。对照组患者接受重组链激酶静脉溶栓治疗,试验组在溶栓治疗基础上,再给予乌司他丁静脉滴注。两组患者分别于治疗前、治疗后24 h及72 h抽取静脉血测定炎症介质hs-CRP、IL-1、IL-10及TNF-α的表达水平。结果治疗后24 h两组患者hs-CRP、IL-1、IL-10及TNF-α表达水平均较治疗前升高,差异有统计学意义(P<0.05),但试验组增加幅度低于对照组(P<0.05)。治疗后72 h两组患者炎症介质水平均显著低于同组治疗前及治疗后24 h(P<0.05),且试验组的降低幅度优于对照组,差异具有统计学意义(P<0.05)。两组在溶栓后住院期间不良反应及不良心血管事件发生情况比较,差异均无统计学意义(P>0.05)。结论 AMI患者溶栓治疗前后应用乌司他丁可有效抑制炎症介质表达水平,减轻心肌缺血再灌注损伤。

Objective To investigate the effect of ulinastatin on the expression of serum inflammatory mediators in pa tients with acute myocardial infarction（AMI） after thrombolysis. Methods 84 patients with AMI in our hospital from January 2017 to December 2017 were selected and randomly divided into the control group and the experimental group with 42 cases in each group. The control group received recombinant streptokinase intravenous thrombolytic therapy, while the experimental group was given intravenous infusion of ulinastatin in the foundation of thrombolytic therapy. Two groups of patients were extracted venous blood to measure the expression levels of inflammatory mediators including hs-CRP, IL-1, IL-10 and TNF-α before treatment, 24 h and 72 h after treatment. Results 24 h after treatment, the expression levels of hs-CRP, IL-1, IL-10 and TNF-α in the two groups were higher than those before the treatment, and the difference was statistically significant （P〈0.05）. However, the increase in the experimental group was lower than that of the control group （P〈0.05）. 72 h after treatment, the levels of inflammatory mediators in the two groups were signif- icantly lower than those before and 24 h after the treatment（P〈0.05）. The decrease in the experimental group was higher than that of the control group and the difference between the two groups was statistically significant（P〈0.05）. There was no significant difference in the incidence of adverse reactions and adverse cardiovascular events between the two groups during hospitalization after thrombolysis（P〉0.05）. Conclusion The use of ulinastatin before and after thrombolytic therapy can effectively inhibit the expression levels of inflammatory mediators and relieve myocardial ischemia reperfusion injury in patients with AMI.