| Objective: Acute myocardial infarction (AMI), which includes ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), is a special group of coronary heart diseases (CHD) .It is caused mainly by thrombosis based on coronary atherosclerosis rupture. Although PCI ( Percutaneous Coronary Intervention) has become an important effective modern method in treatment of coronary heart disease, PCI and stenting may provoke release of debris with distal vessel occlusion and impairment of coronary microperfusion. " slow-flow " or " no-reflow " of phenomenon occur commonly during PCI.Patient subsets that are at particular risk.Treatment of slow-flow can be difficult.Mechanical diatal protection device(DPD), initially employed in carotid angioplasty has been gaining more popularity in recent years during coronary procedure. Many clinical trials have improved that it is feasible, safe and effective to use the DPD in native coronary artery for distal protection against embolism during emergency primary angioplasty in AMI, but its mechanism has not been study clearly, laboratory and biochemical index are also short of study. The studyobserved the change of ET-1 ,NO, NOS, t-PA, PAI-1 ,cTnIand CK-MB in AMI patients during PCI, and analysed the different effects on functions of endothelium fibrinolysis. cardiac troponin I and creatine kinase MB between experimental group and control group, and guide clinic treatment.Methods: Study object came from the hospitalized AMI patients in the Department of Cardiology of Xijing Hospital from June 2003~Mar 2004, 72 patients were last admit to the study according to the include and exclude standard. Then the patients were randomized two groups . experimental group(n=39), contained 36 males and 3females, the average age is (56.28 + 12.53) years; control group(n=33), contained 27 males and 6females, the average age is (59.12+12.59) years. The general information of clinical characteristics and target pathological changes was descriped in detail as followed, we placed 6F catheter into coronary sinus venosus. The collection of blood sample were performed before the first balloon expanding, just after stenting (3min after first stenting), 30min, 2h, and 6h after PCI. Then, we assayed the density of seruma NO, NOS, and plasma t-PA, PAI-1 and ET-1 by ELISA or nitrate reductase method; other samples were collected from the elbow vein 8h, 12h and 24h after PCI, and assay the serum level of cTnl and CK-MB.Furthmore, we observed the difference in incidence rate of cardiovascular events during the stage of hospitalization between the two groups.Result:1 Basic information: There was no significant difference of the age, gender, disease type, complication and medication between two groups. Image analysis also suggest that there was no significant difference of pathological changes and narrow type between twogroups.2 Change of cTnI level in serum: The serum level of cTnI has increased after PCI, experimental group reached peak at 8h after PCI, control group reached peak at 12h after PCI. The serum level of cTnl was significantly lower in experimental group than that in control group at 12h and 24h after PCI (P<0.01).3 Change of CK-MB level in serum: The serum level of CK-MB has increased after PCI, experimental group reached peak at 8h after PCI, control group reached peak at 12h after PCI. The serum level of CK-MB was significantly lower in group 实 than that in group 对 at 12h and 24h after PCI (P<0.01).4 Change of NO level in serum: The serum level of NO was decreased immediately after PCI, and keep decreasing after 2h. The serum level of NO was lower in experimental group than that in control group . There was no statistic significance between two groups(P>0.05)5 Change of vigor of NOS in serum: The serum vigor of NOS was decreased in both groups immediately and 2h after PCI. The vigor of NOS was lower in experimental group than that in control group . There was no statistic significan...
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