缺血后处理对急性心肌梗死患者心率震荡及氧自由基的影响

Effects of ischemic post-treatment on heart rate fluctuation and oxygen free radicals in patients with acute myocardial infarction

目的急性心肌梗死患者经过缺血后处理对心率震荡及氧自由基的影响。方法选取我科2018年1月至2020年1月间急性心肌梗死患者86例,按随机数字表法分组,对照组43例行经皮冠状动脉介入治疗(PCI),观察组43例缺血后处理,再行PCI,1周末,对比两组患者心肌梗死溶栓治疗(TIMI)血流分级、心率震荡及氧自由基、超氧化物歧化酶(SOD)。结果观察组较对照组血流分级1级占比相近1级(P>0.05)、2级、3级较对照组例数增多(P<0.05);治疗后,12~24 h、1周观察组震荡初始、震荡斜率较对照组差异(P<0.05);治疗后,观察组各时间段SOD水平较对照组升高,丙二醛较对照组下降(P<0.05)。结论急性心肌梗死缺血后处理行PCI治疗,能够显著提升血流再灌注效果,纠正心率失常,维持TO及TS在正常范围,抑制游离基,维持SOD活性,降低丙二醛浓度,最终减少心肌损伤面积,提升急性心肌梗死患者预后降低死亡率。

Objective To investigate the effects of ischemic post-treatment on heart rate shock and oxygen free radicals in patients with acute myocardial infarction.Methods 86 cases of patients with acute myocardial infarction(mi)in our hospital from January 2018 to January 2020 were selected and grouped into control group and observation group according to random number table method.The control group with 43 cases were underwent percutaneous coronary intervention(PCI),the observation group with 43 cases of ischemic post-conditioning,PCI,again at the end of the 1 w.Myocardial infarction thrombolysis therapy(TIMI)flow grade,heart rate turbulence and oxygen free radical,superoxide dismutase(SOD)of the two groups of patients were compared.Results Blood flow level 1 in the observation group was higher than that in the control group(P>0.05),and the number of blood flow level 2 and 3 in the observation group was higher than that in the control group(P<0.05).After treatment,the initial and slope of shock in the observation group at 12~24 h and 1W differed from those in the control group(P<0.05).After treatment,the SOD level in the observation group was higher than that in the control group,and malondialdehyde was lower than that in the control group(P<0.05).Conclusion PCI after ischemic post-treatment of acute myocardial infarction can significantly improve the effect of blood flow reperfusion,correct arrhythmia,maintain TO and TS in the normal range,inhibit free radicals,maintain SOD activity,reduce malondialdehyde concentration,and finally reduce the area of myocardial injury,improve the prognosis and reduce the mortality of patients with acute myocardial infarction.