目的观察前列地尔对急性心肌梗死PCI术后的心肌保护作用。方法将急性心肌梗死行急诊冠脉介入(PCI)治疗患者120例随机分为前列地尔组与对照组各60例。对照组患者入院后90min内给予急诊冠脉介入治疗,按照2004年急性心肌梗死诊疗指南给予规范用药。前列地尔组在对照组治疗基础上术前及术后各给予前列地尔10μg静脉推注。比较2组患者治疗后0h、6h、12h、18h、24h、36h、48h血清肌酸激酶同工酶(CK-MB)、肌钙蛋白I水平变化。观察2组患者手术后6h心电图抬高ST段回落幅度(%),酶联免疫吸附法检测患者血清超敏C反应蛋白(hs-CRP)水平变化。结果治疗后前列地尔组患者血清CK-MB水平于术后12h达高峰,后逐渐下降;对照组患者术后血清CK-MB水平于18h达高峰后呈下降变化。相同时间点比较,前列地尔组达峰时间提前,峰值幅度下降,2组对比差异有统计学意义(P<0.05)。前列地尔组血清肌钙蛋白I水平于术后6h达到高峰后,呈逐渐下降趋势;对照组患者血清肌钙蛋白I水平也于术后6h达高峰后下降,但峰值幅度高于前列地尔组,2组比较差异有统计学意义(P<0.05)。PCI术后6h心电图抬高ST段回落幅度与对照组比较较高,hs-CRP水平明显减少,2组比较差异有统计学意义(P<0.05)。结论急性心肌梗死患者行PCI治疗前后给予前列地尔治疗可显著减少血清中炎性反应因子水平,减轻心肌损伤程度,起到保护心肌功能作用。 Objective To observe the myocardial protective effect of prostaglandin on acute myocardial infarction after PCI. Methods A total of 120 patients undergoing acute coronary intervention (PCI) with acute myocardial infarction were randomly divided into alprostadil group and control group, 60 cases each. Patients in the control group were given emergency coronary intervention within 90 minutes after admission and were given standard medication according to 2004 guidelines for diagnosis and treatment of acute myocardial infarction. Alprostadil group in the control group based on the treatment of preoperative and postoperative alprostadil 10μg intravenous injection. The changes of serum CK-MB and Troponin I were compared between the two groups at 0h, 6h, 12h, 18h, 24h, 36h, 48h after treatment. The changes of ST-segment depression (%) in 6 hours after operation and the changes of serum hs-CRP level in patients were observed by enzyme-linked immunosorbent assay. Results Serum levels of CK-MB in the alprostadil group reached a peak at 12 hours after treatment, and then gradually decreased. CK-MB levels in the control group decreased after reaching the peak at 18 hours. Compared with the same time point, the peak time of alprostadil group was earlier and the peak amplitude decreased. The difference between the two groups was statistically significant (P <0.05). The level of serum troponin I in the alprostadil group decreased gradually at 6 hours after the operation, and the serum level of troponin I in the control group also decreased after reaching the peak at 6 hours after operation, but the peak amplitude was higher than that in the alprostadil Group, the difference between the two groups was statistically significant (P <0.05). 6 h after PCI ECG ST-segment drop-off amplitude was higher than the control group, hs-CRP levels were significantly reduced, the difference between the two groups was statistically significant (P <0.05). Conclusions Prostaglandin treatment before and after PCI in patients with acute myocardial infarction can significantly reduce the levels of inflammatory response factors in serum, reduce the degree of myocardial injury, and play a role in the protection of myocardial function.