【摘要】：目的心肺轉(zhuǎn)流(cardiopulmonary bypass,CPB)瓣膜置換術(shù)可誘發(fā)心肌缺血-再灌注損傷,影響心功能恢復(fù)。文中旨在探討體外循環(huán)前靜脈輸注燈盞花素對(duì)CPB瓣膜置換術(shù)患者心肌缺血-再灌注損傷的影響。方法選擇河北北方學(xué)院附屬第一醫(yī)院2013年5月至2014年7月間40例全身麻醉下行CPB瓣膜置換術(shù)患者。采用隨機(jī)數(shù)字表法,將患者隨機(jī)分為對(duì)照組及燈盞花素組,每組20例。麻醉誘導(dǎo)完成后,采用微量泵分別向?qū)φ战M以及燈盞花素組靜脈輸注15 m L等滲鹽水和劑量為0.75 mg/kg的燈盞花素,30 min內(nèi)輸注完畢。分別于切皮前(T0)、主動(dòng)脈開放后30 min(T1)、6 h(T2)、12 h(T3)、24 h(T4)5個(gè)時(shí)間點(diǎn)采集頸內(nèi)靜脈血,測(cè)定血清心肌肌鈣蛋白I(cardiac troponin-I,c Tn I)、肌酸激酶同工酶(creatine kinase isoenzyme,CK-MB)及超氧化物歧化酶(superoxide dismutase,SOD)的濃度。結(jié)果與切皮前比較,2組主動(dòng)脈開放后30min、6 h的c Tn I和CK-MB濃度均明顯升高(P0.05),在T2時(shí)達(dá)峰值,而SOD活性均明顯下降(P0.05)。與對(duì)照組比較,T1-T4時(shí)燈盞花素組c Tn I和CK-MB濃度明顯降低,SOD濃度明顯升高(P0.05)。結(jié)論體外循環(huán)前靜脈輸注燈盞花素可減輕CPB下瓣膜置換術(shù)患者心肌缺血-再灌注損傷,推測(cè)其機(jī)制與抗氧化應(yīng)激作用有關(guān)。
[Abstract]:Objective Cardiopulmonary bypass (cardiopulmonary bypass,CPB) valve replacement can induce myocardial ischemia reperfusion injury and affect cardiac function recovery. The purpose of this study was to investigate the effect of breviscapine infusion before cardiopulmonary bypass (CPB) on myocardial ischemia-reperfusion injury in patients undergoing CPB valve replacement. Methods 40 patients underwent CPB valve replacement under general anesthesia from May 2013 to July 2014 in the first affiliated Hospital of Hebei North University. Patients were randomly divided into control group and breviscapine group with 20 cases in each group. After anesthesia induction was completed, the control group and breviscapine group were infused intravenously with 15 mL isoosmotic saline and 0.75 mg/kg breviscapine for 30 min respectively. Jugular vein blood was collected at 5 time points (T _ 0), 30 min (T _ 1) ~ 6 h (T _ 2) and 12 h (T _ 3) and 24 h (T _ 4), respectively. The serum levels of cardiac troponin I (cardiac troponin-I,c Tn I), creatine kinase isoenzyme (creatine kinase isoenzyme,CK-MB) and superoxide dismutase (superoxide dismutase,SOD) were measured. Results the concentrations of c Tn I and CK-MB increased significantly at 30 min after aorta opening in both groups (P0.05), and reached the peak at T2, while the activity of SOD decreased significantly (P0.05). Compared with the control group, the concentration of c Tn I and CK-MB in breviscapine group was significantly lower than that in control group (P0.05). Conclusion Breviscapine infusion before cardiopulmonary bypass can attenuate myocardial ischemia-reperfusion injury in patients undergoing valve replacement under CPB, and its mechanism may be related to antioxidant stress.
【作者單位】： 河北北方學(xué)院研究生學(xué)院;河北北方學(xué)院附屬第一醫(yī)院麻醉科;
【分類號(hào)】：R654.2

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