【摘要】 目的探讨N-乙酰半胱氨酸(NAC)对心肌梗死再灌注心律失常的影响及可能的机制。方法行急诊经皮冠状动脉介入治疗(PCI)的急性心肌梗死患者81例,随机分为对照组(n=40)及NAC组(n=41),观察两组再灌注后3d内发生的心律失常及两组间血清超氧化物歧化酶(SOD)活性、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、肌钙蛋白Ⅰ(cTnI)的变化。结果 (1)经治疗后对照组发生心律失常31例(77.5%),NAC组发生心律失常21例(51.2%),NAC组较对照组再灌注心律失常发生率低(P<0.05)。(2)NAC组心肌梗死患者血清SOD活性明显较对照组高(P<0.01)。(3)NAC组血清CK-MB、CK、cTnI峰值水平明显低于对照组(P<0.05)。结论 NAC对心肌梗死再灌注心律失常的发生有明显的预防作用,能够减轻心肌损伤,其作用机制可能是通过抗过氧化反应来减少心律失常的发生。更多还原

【Abstract】 Objective To investigate the effects of N-acetyicysteine on the incidence of reperfusion arrhythmias(RA) in patients with acute myocardial infarction (AMI),in addition the possible mechanism of action.Methods 81 patients with presumptive clinical diagnosis of AMI agreeing with direct PCI treatment were randomly divided into control group and N-acetyicysteine treatment group,the incidence of RA and the levels of blood SOD,CK-MB,CK,cTnI were recorded in all the patients.Results (1)The incidence of RA was significantly lower in the treatment group(51.2%)than that in the control group (77.5%)(P<0.05).(2) Blood SOD level in the treatment group were much higher than that in the control group (P<0.01).(3)The peak value of blood CK-MB,CK,cTnI in the treatment group were lower than that in the control group (P<0.05).Conclusions The results suggested that N-acetyicysteine can effectively prevent RA in direct PCI of AMI,and reduce myocardium injury,partly through inhibiting peroxidation.更多还原