Perioperative application of salvianolate on oxidative stress and plasma IMD/ADM2 in patients with acute myocardial infarction undergoing PCI

围术期应用丹参多酚酸盐对急性心肌梗死PCI患者氧化应激及血浆IMD/ADM2的影响

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作者:Qiang Zhang, Fengjun Jiao, Chongjun Hua

Abstract

The present study was conducted to investigate the effects of salvianolate on perioperative oxidative stress and plasma Intermedin/adrenomedullin 2 (IMD/ADM2) in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). The clinical data of 108 patients with AMI treated by PCI were retrospectively analyzed. According to the use of salvianolate in perioperative period, the patients were divided into the study group (n=62) and the control group (n=46). The control group was given routine treatment while the study group was given routine treatment combined with intravenous infusion of salvianolate (200 mg administered once at 24 h before operation, once/day after operation, 1 week later, the curative effect was observed). The changes in levels of hemodynamic indexes [fibrinogen (FIB), platelet aggregation rate (PAG), plasma viscosity, packed-cell volume (PCV)], oxidative stress indexes [superoxide dismutase (SOD), glutathione peroxidase (GSH Px)], cardiac function indexes [left ventricular ejection fraction (LVEF), cardiac output (CO)], related biochemical indexes [high-sensitivity C-reactive protein (hs-CRP), N-terminal pro brain natriuretic peptide (NT proBNP)] and plasma IMD/ADM2 in the two groups at 24 h pre-operation and the 8th day postoperation were analyzed. On the 8th day post-operation, hemodynamic indexes such as FIB (3.3±1.0 and 3.9±0.9) g/l, PAG (20.6±6.5 and 41.6±7.7)%, plasma viscosity (1.1±0.5 and 1.7±0.6) mPa•s/120 s-1 and PCV (40.0±3.8 and 45.5±3.7)%, the related biochemical indexes such as hs-CRP (55.1±4.8 and 79.3±5.3) mg/l and NT-proBNP (435.6±305.2 and 788.6±310.8) ng/l in the two groups were significantly decreased compared to those pre-operation; the differences were statistically significant (P<0.05). The oxidative stress indexes such as SOD (43.6±1.9 and 24.2±2.0) U/ml and GSH-Px (822.6±13.52 and 742.6±62.6) enzyme activity unit, the cardiac function indexes such as LVEF (45.1±3.5 and 41.9±3.3)% and CO (4.6±0.5 and 4.1±0.5) l/min and plasma IMD/ADM2 (163.5±20.2 and 144.2±22.5) pg/ml in the two groups were significantly increased compared to those pre-operation; the differences were statistically significant (P<0.05). In conclusion, applying intravenous infusion of salvianolate in patients with AMI during perioperative period of PCI can effectively improve the oxidative stress reaction and have positive effects on regulating plasma IMD/ADM2 level, which promoted cardiac function recovery and enhances myocardial perfusion volume.

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