尼可地尔联合丹红注射液治疗对经皮冠状动脉介入术后心肌缺血再灌注损伤、氧化应激反应、免疫细胞因子影响的临床观察

Clinical observation of effect of nicorandil combined with Danhong injection on myocardial ischemia-reperfusion injury,oxidative stress response and immunocytokines after PCI

目的研究尼可地尔联合丹红注射液治疗对经皮冠状动脉介入(PCI)术后心肌缺血再灌注损伤、氧化应激反应、免疫细胞因子的影响。方法前瞻性选择2018年2月至2019年9月期间安徽省宿州市第一人民医院进行PCI治疗且发生术后心肌缺血再灌注损伤的患者,随机分为接受尼可地尔联合常规治疗的尼可地尔联合丹红组(n=52)、接受常规治疗的丹红治疗组(n=52)。治疗前及治疗后5d时,测定血清中心肌损伤标志物[磷酸肌酸激酶(CK-MB)、肌钙蛋白I(cTnI)、脑钠肽(BNP)]、氧化应激标志物[丙二醛(MDA)、内皮素-1(ET-1)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSP-Px)、过氧化氢酶(CAT)]及免疫细胞因子[超敏C反应蛋白(hs-CRP)、白细胞介素-1β(IL-1β)、白细胞介素-4(IL-4)、白细胞介素-37(IL-37)]的含量。结果治疗后5d,两组患者血清CK-MB、cTnI、BNP、MDA、ET-1、hs-CRP、IL-1β、IL-4、IL-37较组内治疗前均明显降低,SOD、GSP-Px、CAT较组内治疗前均明显升高(P<0.05),且尼可地尔联合丹红组患者血清CK-MB、cTnI、BNP、MDA、ET-1、hs-CRP、IL-1β、IL-4、IL-37明显低于丹红治疗组,SOD、GSP-Px、CAT明显高于丹红治疗组(P<0.05)。结论尼可地尔联合丹红注射液治疗对PCI术后的心肌缺血再灌注损伤具有减轻作用,能够抑制氧化应激反应的激活、免疫细胞因子的分泌。

Objective To study the effects of nicorandil combined with Danhong injection on myocardial ischemia reperfusion injury,oxidative stress and immunocytokines after percutaneous coronary intervention(PCI).Methods Patients received PCI and developed postoperative ischemia reperfusion injury in the First People's Hospital of Suzhou City during February 2018 to September 2019 were prospectively selected and randomly divided into the nicorandil combined with danhong group receiving nicorandil combined with routine treatment(n=52),the danhong therapy group receiving routine treatment(n=52).The levels of serum cardiac muscle injury markers,oxidative stress markers[creatine kinase MB(CK-MB),troponin I(cTnI),brain natriuretic peptide(BNP)],oxidative stress markers[malondialdehyde(MDA),endothelin-1(ET-1),superoxide dismutase(SOD),glutathione peroxidase(GSP-Px),catalase(CAT)]and immunocytokines[high-sensitivity C-reactive protein(hs-CRP),interleukin-1β(IL-1β),interleukin-4(IL-4),interleukin-37(IL-37)]were measured before treatment and 5 days after treatment.Results Five days after treatment,serum CK-MB,cTnI,BNP,MDA,ET-1,hs-CRP,IL-1β,IL-4,IL-37 in both groups were significantly lower than those before treatment,SOD,GSP-Px,CAT were significantly higher than those before treatment(P<0.05),and serum CK-MB,cTnI,BNP,MDA,ET-1,hs-CRP,IL-1β,IL-4,IL-37 in nicorandil combined with danhong group were significantly lower than those in danhong therapy group(P<0.05),SOD,GSP-Px and CAT were significantly higher than those in the danhong therapy group(P<0.05).Conclusion Nicorandil combined with Danhong injection can inhibit myocardial ischemia reperfusion injury,oxidative stress response and immunocytokine secretion after PCI.