尼可地尔联合国产重组人脑利钠肽对AMI急诊PCI术后慢血流患者红细胞渗透脆性及氧化应激损伤的影响

Effects of nicorandil combined with natriuretic peptide on erythrocyte osmotic fragility and oxidative stress injury in slow blood flow patients with AMI after emergency PCI

目的:探讨尼可地尔联合国产重组人脑利钠肽对急性心肌梗死(AMI)急诊PCI术后慢血流患者红细胞渗透脆性及氧化应激损伤的影响。方法:将2016-06-2017-06我院收治的急诊PCI术后发生慢血流的患者90例随机分为观察组与对照组,每组各45例。其中对照组在常规治疗基础上加用尼可地尔,观察组则在常规治疗基础上加用尼可地尔联合国产重组人脑利钠肽。对比两组患者心肌灌注情况、心功能、红细胞渗透性及氧化应激指标水平差异。结果:术后第7天,观察组室壁运动积分指数(WMSI)与左心室收缩末期容积指数(LVESVI)明显低于对照组,左室射血分数(LVEF)明显高于对照组(均P<0.05)。观察组髓过氧化物酶(MPO)、丙二醛(MDA)、红细胞渗透脆性最大抵抗值(OFmax)、红细胞渗透脆性最小抵抗值(OFmix)、红细胞平均体积(MCV)、溶血率(0.45/0)及溶血率(0.45/0.15)水平明显低于对照组(均P<0.05);超氧化物歧化酶Orgotein(SOD)及NQO-1水平均高于对照组(均P<0.05)。结论:尼可地尔联合国产重组人脑利钠肽可明显降低AMI急诊PCI术后慢血流患者氧化应激损伤,提高红细胞渗透脆性,改善心功能及血流灌注能力。

Objective:To investigate effects of nicorandil combined with natriuretic peptide on erythrocyte osmotic fragility and oxidative stress injury in slow blood flow patients with acute myocardial infarction (AMI) after emergency PCI.Method:Ninety patients with slow blood flow after emergency PCI who were admitted to our hospital from June 2016 to June 2017 were randomly divided into observation group and control group with 45 people in each group.Patients in control group were given nicorandil on the basis of conventional treatment,and patients in observation group were given nicorandil combined with natriuretic peptide on the basis of conventional treatment.Differences in myocardial perfusion,cardiac function,erythrocyte permeability,and oxidative stress were compared between the two groups.Result:On the 7th day after surgery,the wall motion score index (WMSI)and left ventricular end-systolic volume index (LVESVI)were significantly lower,while the left ventricular ejection fraction (LVEF)was significantly higher in observation group than those in control group (all P<0.05).Myeloperoxidase (MPO),malondialdehyde (MDA),erythrocyte osmotic fragility maximum resistance value (OFmax),erythrocyte osmotic fragility minimum resistance value (OFmix),mean corpuscular volume (MCV)and hemolysis rate (0.45/0.15) level were significantly lower,while superoxide dismutase orgotein (superoxide dismutase,SOD)and NQO-1 were higher in observation group than those in control group (all P<0.05).Conclusion:Nicorandil combined with natriuretic peptide can significantly reduce oxidative stress injury in slow blood flow patients with AMI after emergency PCI,which can improve erythrocyte osmotic fragility,cardiac function and blood perfusion ability.