大剂量维生素C对心肌缺血/再灌注损伤中TXA_2水平的影响

Effects of vitamin C on thromboxane A_2 level during the course of myocardial ischemia/reperf usion in AMI patients/

目的:研究维生素C对心肌缺血/再灌注损伤过程中血栓素A_2(TXA_2)水平的影响。方法:103例急性心肌梗死(AMI)患者被随机、双盲分成溶栓组(60例)和未溶栓组(43例);溶栓组又分为溶栓前使用大剂量维生素C组(溶Vc组,30例)和溶栓前未使用大剂量维生素C组(溶Nc组,30例);未溶栓组又分为使用大剂量维生素C组(未溶Vc组,22例)和未使用大剂量维生素C组(未溶Nc组,21例)。测定各组血浆TXB_2水平,连续3天。结果:较之溶Nc组溶通组,溶Vc组溶通者溶栓后1、2、3日TXB_2水平显著降低(P<0.01,<0.05,<0.05)。与溶Vc未通者比较.溶Vc组溶通者TXB_2水平第1、2日显著升高(P<0.01,<0.05);溶Nc组溶通者第1、2日TXB_2水平升高更加显著(P<0.01,<0.01)。未溶栓组与溶栓未通者第2、3日TXB_2水平比较无显著差异。结论:维生素C有显著降低溶栓再通者TXA_2水平,减轻再灌注损伤的作用。

Objective: To investigate the effect of vitamin C on thromboxane A2 (TXAz) level during the course of myocardiac ischemia/reperfusion in patients with acute myocardial infarction (AMI). Methods: A total of 103 AMI patients were randomly divided into 4 groups: Group of thrombolysis associated with vitamin C treatment (thrombolysis Vc group), group of thrombolysis no associated vitamin C treatment (thrombolysis Nc group), group of no-thrombolysis associated with vitamin C treatment ( no-thrombolysis Vc group), group of no-thrombolysis no associated vitamin C treatment ( no-thrombolysis Nc group). The concentration of TXA2 was measured during the first 3 days after thrombolysis treatment. Results; Compared with reperfusion cases of thrombolysis Nc group, the concentration of TXAz significantly decreased during the 1st, 2nd, 3rd day after thrombolysis treatment in reperfusion cases of thrombolysis Vc group (P<0. 01, <0. 05, <0. 05). Compared with no-reperfusion cases of thrombolysis Vc group, the concentration of TXAz significantly increased during the 1st, 2nd day in reperfusion cases of thrombolysis Vc group (P<0.01, <0. 05), it more increased in reperfusion cases of thrombolysis Nc group (P<0. 01, <0. 01). The differences of TXAz level during the 2nd, 3rd day between no-thrombolysis cases and no-reperfusion cases were no significant. Conclusion: Vitamin C can decrease the TXAz level and reperfusion injury in reperfusion cases of thrombolysis treatment.