| Objective:In this experiment, we made patients to use macrolides antibiotics-roxithromycin, who were based on emergency percutaneous coronary intervention (PCI) or elective PCI treatment with acute myocardial infarction. We observed its effect on acute myocardial infarction (AMI) patients with postoperative reperfusion injury, and we monitored the data received by neutrophils apoptosis, the change of inflammatory cytokines, endothelial function and cardiac function, we used correction TIMI frame number (CTFC) to assessment the intervention group and control group's artery blood flow velocity operation of coronary, all of them is to research the possible mechanisms which is roxithromycin played, thus to provide the basis for prevention and intervention about acute myocardial ischemia-reperfusion injury.Methods:Selected 98 patients with acute myocardial infarction who had the PCI treatment in our departments. Their average age is (63.1+ 12.1) years old, all the patients were accorded with the WHO prescribed acute myocardial infarction diagnostic criteria, randomly divided them into four groups:Emergency PCI treatment group (group EI):the patiernts should be take aspirin 300mg and clopidogrel 300mg before PCI treatment. Emergency PCI therapy roxithromycin interention group (EIApo group):the patiernts should be take aspirin 300mg, clopidogrel 300mg and roxithromycin 300mg before PCI treatment. Elective PCI treatment group (SI group):the patiernts should be take aspirin 100mg/d and clopidogrel 75mg/d three days ago before PCI treatment. Elective PCI therapy roxithromycin interention group (SIApo group):the patiernts should be take aspirin 100mg/d, clopidogrel 75mg/d and roxithromycin 300mg twice a day (bid) three days ago before PCI treatment. Then we collected the blood specimens, using thiobarbituric acid(TBA method) to detect plasma malondialdehyde (MDA), using the ELASE method to detect interleukin-1, interleukin-6, interleukin-10 (IL,10-1, IL-6, IL-10), tumor necrosis factor (TNF-α) when preoperative and postoperative in peripheral blood test and the neutrophils apoptosis ratio (PMNs) were measured. Using correction TIMI frames (CTFC) to evaluate the coronary flow velocity. Application of color doppler ultrasound diagnostic systems to measure brachial artery vessels diameter, detection of endothelial dependence diastolic function and cardiac function. Monitoring endothelial function and cardiac function at the same time. The study dates were analyzed by SPSS 11.0. Multiple comparison use single-factor analysis of variance, pairwise comparison between the two groups use q test, time-dependent variable data use of repeated measure analysis of variance of data.Results:The emergency roxithromycin intervention group neutrophils apoptosis rate was higher than control group, the way CTFC, MDA concentration, TNF-α, IL-1, IL-6 concentration were less than control group, but the IL-10 and the brachial artery endothelial dependence relatively controls diastolic function was higher than those in the control group. After 8 weeks of PCI, when we take the echocardiogram, we found the EF was less than control (32.9±1.8 vs 52.7±2.4, P<0.05 32.1±5.3 vs 19.3±2.4, respectively, all P<0.05). Elective intervention group between two groups had the similar conclusion, the change was no obvious difference between the two groups.Conclusions:Roxithromycin could play protective role in myocardium from reperfusion injuries. Such heart protection may be related to the macrolides antibiotics.which can make the PMNs apoptosis, it also can strengthen the antioxidation effect of myocardial cell, thus alleviate to tissue damage, increase of the inflammatory response in the negative adjustment factor, reduce inflammation factors, protecting endothelial normal function and so on. This new discovery provides new basis and thoughts on prevention acute myocardial ischemia reperfusion in clinically. |
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