论文部分内容阅读
目的探讨螺内酯干预对经皮冠状动脉介入治疗(PCI)围手术期心肌保护作用的可能机制。方法择期PCI患者121例随机分为治疗组(A组,63例)与对照组(B组,58例),A组在常规治疗基础上口服螺内酯20~40 mg/d,B组给予安慰剂。测定PCI非手术侧冠脉内术前与术后平均动脉压(MAP),同时测定并比较术后血醛固酮(Ald)、肌钙蛋白I(cTn-I)、C-反应蛋白(CRP)浓度变化。分析cTn-I变化值(ΔcTn-I)与其它变量间的相关性。结果二组术后Ald、cTn-I、CRP浓度均较术前有明显升高(P<0.05),A组cTn-I明显低于B组(P<0.05);A组术后的MAP均明显高于B组(P<0.05);相关分析表明,ΔcTn-I与ΔCRP、ΔMAP间存在明显的相关性(r=0.61、r=0.38,P<0.05)。结论螺内酯可增加PCI术后非手术侧冠脉的灌注;其机制可能与其能促进Ald的非基因组作用有关。
Objective To investigate the possible mechanism of intervention of spironolactone for perioperative myocardial protection in percutaneous coronary intervention (PCI). Methods A total of 121 patients with elective PCI were randomly divided into treatment group (group A, n = 63) and control group (group B, n = 58). Group A received spironolactone 20-40 mg daily on the basis of routine treatment and group B received placebo . The preoperative and postoperative mean arterial pressure (MAP) were measured in the non-surgical intra-coronary coronary arteries and the concentrations of Ald, cTn-I and C-reactive protein (CRP) Variety. The correlation between cTn-I changes (ΔcTn-I) and other variables was analyzed. Results The concentrations of Ald, cTn-I and CRP in the two groups were significantly higher than those before the operation (P <0.05), while the cTn-I in group A was significantly lower than that in group B (P <0.05) (P <0.05). Correlation analysis showed that there was a significant correlation between ΔcTn-I and ΔCRP and ΔMAP (r = 0.61, r = 0.38, P <0.05). Conclusion Spironolactone can increase the perfusion of non-surgical coronary arteries after PCI. The mechanism may be related to the promotion of non-genomic Ald.