论文部分内容阅读
目的 探讨尿激酶 (UK)溶栓治疗急性心肌梗死 (AMI)期间血清一氧化氮 (NO)的动态变化和临床意义。方法 选择 3 0例AMI患者行溶栓治疗 (UK 10 0～ 15 0万u加入生理盐水 10 0mL静滴 ) ,在溶栓前和溶栓后第 2、4、6天分别取静脉血检测血清NO、超氧化物歧化酶 (SOD)、丙二醛 (MDA)和总抗氧化能力 (TAOC) ,并同步检测血气分析。结果 治疗组溶栓前NO、SOD、TAOC水平明显低于对照组 (P <0 .0 0 1) ,MDA水平明显高于对照组 (P <0 .0 0 1) ;溶栓第 2天后NO、SOD、TAOC水平逐渐升高 ,MDA水平逐渐降低 ,至第 6天均恢复到对照组水平 ,与溶栓前比较差异非常显著 (P <0 .0 0 1) ;血气分析示AMI患者入院时低氧血症严重 ,经溶栓后氧分压(PaO2 )明显升高 (P <0 .0 0 1) ,NO水平与PaO2 呈正相关 (r=0 .2 78,P <0 .0 5 )。结论 AMI患者心肌在缺血缺氧时血清NO生成减少 ,机体抗氧化能力降低 ,UK溶栓治疗AMI能明显改善这一病理生理过程。
Objective To investigate the dynamic changes and clinical significance of serum nitric oxide (NO) during urokinase (UK) thrombolysis in patients with acute myocardial infarction (AMI). Methods Thirty patients with AMI were enrolled in this study. Thrombolysis was performed in 10 AMI patients (UK 10 0 ~ 150 000 u added with 10 0 mL intravenous infusion of normal saline). Venous blood was taken before and after thrombolysis NO, superoxide dismutase (SOD), malondialdehyde (MDA) and total antioxidant capacity (TAOC), and simultaneous detection of blood gas analysis. Results Before treatment, the levels of NO, SOD and TAOC in the treatment group were significantly lower than those in the control group (P <0.01). The levels of MDA in the treatment group were significantly higher than those in the control group (P <0.01) , SOD, TAOC levels gradually increased, MDA levels gradually decreased to the first 6 days were restored to control group levels, compared with before thrombolysis difference was significant (P <0.01); blood gas analysis showed AMI patients admitted to hospital Hypoxemia was severe, PaO 2 was significantly increased after thrombolytic therapy (P0.01), NO was positively correlated with PaO 2 (r = 0.782, P0.05) . Conclusions Myocardial ischemia and hypoxia in AMI patients reduced the production of NO and reduced the antioxidant capacity in the AMI patients. The thrombolytic therapy with AMI in AMI patients significantly improved the pathophysiological process.