Nickita SEMIGOLOVSKY, Konstantin SHPERLING, Stanislav Obolensky
Sankt-Petersburg Medical Academy of postgraduate education, Russia

As hypoxia and reperfussion are the common features of acute myocardial infarction (AMI), treatment with antioxydants / antihypoxants (AH) and hyperbarooxygenation (HBO) may be indicated in such cases.
In order to evaluate the comparative efficacy of various AH and HBO 385 patients in acute phase of MI in representative groups of 25-40 patients in addition to conventional therapy received 2-7 HBO procedures (1,2-2,0 Atm, 40-60 min daily or twice a day) or one of the next AH: amthizol (2-4 mg/kg/tid IV administered), olifen (2-4 mg/kg/tid IV), inosin (3-6 mg/kg/tid IV), cytochrom C (0.15-0.60 mg/kg/tid IV), mildronat (5-10 mg/kg/tid IV), pyracetam (10-150 mg/kg/tid IV), lithii oxybutirate (10-15 mg/kg/tid IM), aspisol (10-15 mg/kg/tid IV), solcoseryl (0,3 g/kg/tid IV), ubiquinone (0.8-1.2 mg/kg/tid orally administered), bemithil (5-7 mg/kg/tid orally), trimetazidine (0.8-1.2 mg/kg/tid orally). The treatment with AH had began not later than 18 h from the AMI symptoms onset. Control groups consisted of 25 patients (laboratory-ECG dynamics) and 235 patients (mortality rate).
Besides usual laboratory (including cardiospecific enzymes, blood gas analysis, level of mononuclear leucocytes, coagulological parameters etc.) and ECG-dynamics, the mean prognostic mortality rate (pMR) for every group on then day of admission was calculated (with the help of A.Peel prognostic index, 1962) and its difference with real MR (MR=pMR - real MR). The AMI -recidive frequency (RF) in observed groups was analysed too. The mean integrative original index (“reiting”) for velocity of explored parametres normalization was calculated for each group also.
Results of investigation showed positive influence of most AH on clinical features of AMI, reduction of complication frequency (pain, arrythmia, fever), RF, MR, acceleration of various parameters normalisation (CPC, LDH, AsAT activity, systolic ECG index, pO2, pCO2, amount of lymphocytes, monocytes, fibrinigen, prothrombin index, time of plasma recalcification etc.).
High efficacy in intensive care of AMI patients was achieved with addition of amthizol, pyracetam, lithii oxybutirate or ubiquinone (leaders in 3 scales: MR, RF, laboratory-ECG “reiting”), mean efficacy - with cytochrom C, inosin, mildronat or olifen (2-scale leaders). Solcoseryl, bemithil, trimetazidine and aspisol showed weak protective possibilities in explored doses. HBO effectiveness was very low according to all of 3 scale results.
Mechanisms of pharmacological action of AH and HBO are discussed.