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[目的]探讨急诊PCI术后脂质过氧化产物丙二醛(MDA)的动态变化规律及依达拉奉对其的影响。[方法]56例初发AMI患者被随机分为对照组与干预组,干预组入院时即给予依达拉奉静滴,疗程7d。检测术前即刻、术后1、6、12、24、48h、7d血浆丙二醛(MDA)水平,同时检测血浆CK-MB峰值浓度,发病d7行超声心动图评价左室功能,观察两组术后心肌缺血再灌注损伤临床事件与不良反应。[结果]急诊PCI再灌注治疗后对照组各时点MDA均较术前显著升高,再灌注后1h达峰值,而后逐渐下降,d7时仍高于术前水平,干预组术后各时点MDA水平均较对照组显著降低,差异有统计学意义(P﹤0.05);干预组心肌缺血再灌注损伤临床事件发生率及CK-MB峰值浓度较对照组明显降低,左室功能指标明显优于对照组,差异有统计学意义(P﹤0.05),两组均未见不良反应。[结论]AMI患者急诊PCI术后血浆脂质过氧化标志物丙二醛显著升高,依达拉奉能减轻其升高水平,减轻心肌缺血再灌注损伤。
[Objective] To investigate the dynamic changes of lipid peroxidation product malondialdehyde (MDA) after emergency PCI and the effect of edaravone on it. [Method] Fifty-six patients with initial AMI were randomly divided into control group and intervention group. The patients in the intervention group were treated with edaravone intravenously for 7 days. The levels of malondialdehyde (MDA) were measured immediately before operation and at 1, 6, 12, 24, 48 and 7 days after operation. Meanwhile, the peak plasma concentration of CK-MB was detected. The left ventricular function was evaluated by echocardiography at d7. Postoperative myocardial ischemia / reperfusion injury clinical events and adverse reactions. [Results] After the PCI reperfusion, the MDA in the control group at each time point was significantly higher than that before the operation and peaked at 1 hour after reperfusion, and then gradually decreased. At the same time, the level of MDA was still higher than that before operation in the intervention group (P <0.05). The incidence of clinical events and peak CK-MB concentration in myocardial ischemia-reperfusion injury in the intervention group were significantly lower than those in the control group and the indexes of left ventricular function were significantly better In the control group, the difference was statistically significant (P <0.05), no adverse reactions in both groups. [Conclusion] Malondialdehyde (MDA), a marker of lipid peroxidation in patients with acute myocardial infarction, is significantly increased in AMI patients. Edaravone can reduce the level of malondialdehyde and alleviate myocardial ischemia-reperfusion injury.