磷酸肌酸钠预先给药对2型糖尿病患者心肌缺血-再灌注损伤的影响

发布时间：2018-01-18 15:23

本文关键词：磷酸肌酸钠预先给药对2型糖尿病患者心肌缺血-再灌注损伤的影响　出处：《临床麻醉学杂志》2015年01期 　论文类型：期刊论文

【摘要】：目的探讨磷酸肌酸钠预先给药对2型糖尿病心脏瓣膜置换术患者心肌缺血-再灌注损伤的影响。方法择期行二尖瓣置换术的2型糖尿病患者100例,年龄41~71岁,体重41~78kg,随机均分为两组:糖尿病对照组(NS组)和磷酸肌酸钠预先给药组(CP组)。CP组切皮时开始中心静脉输注磷酸肌酸钠10g(溶于100ml生理盐水),输注时间60min,NS组静脉输注等容量生理盐水,分别于麻醉前、术后第1天和第3天采集颈内静脉血样,检测血清磷酸肌酸激酶(CK)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB),测定心肌肌钙蛋白I浓度(cTnI),观察自动复跳情况,记录术后3d内使用血管活性药物情况和心血管不良事件发生情况。结果与麻醉前比较,术后第1天两组患者血清CK、LDH、CK-MB、cTnI浓度均明显升高(P0.05);术后第3天NS组CK、LDH、CK-MB、cTnI浓度明显升高(P0.05)。与NS组比较,CP组术后第1天和第3天血清CK、LDH、CK-MB、cTnI浓度明显降低(P0.05),术后3d内使用正性肌力药物的例数和术后心血管事件发生例数明显减少(P0.05),术中心脏自动复跳例数明显增多(P0.05)。结论磷酸肌酸钠预先给药可减轻2型糖尿病患者心肌缺血-再灌注损伤,改善预后。
[Abstract]:Objective to investigate the effect of pre-administration of creatine phosphate sodium on myocardial ischemia-reperfusion injury in patients with type 2 diabetic heart valve replacement. Methods 100 patients with type 2 diabetes underwent mitral valve replacement. The age was 41 ~ 71 years old and the weight was 41 78 kg. They were randomly divided into two groups: diabetic control group (NS group) and sodium phosphocreatine group (group C) and group C (n = 10 g), and group C (n = 10) received creatine phosphate (10 g) by intravenous infusion of creatine phosphate (10 g) at the time of skin incision. Soluble in 100ml saline. The blood samples of internal jugular vein were collected before anesthesia, on the 1st and 3rd day after operation, and the serum creatine kinase (CK) was detected. Lactate dehydrogenase (LDH) and creatine kinase isoenzyme (CK-MBN) were used to detect cardiac troponin I (cTnI). Results compared with those before anesthesia, the serum CK LDH CK-MB of the two groups were recorded on the first day after operation. The concentration of cTnI increased significantly (P 0.05). On the 3rd day after operation, the level of CK LDHnI and CK-MBN cTnI in NS group was significantly higher than that in NS group, and compared with that in NS group on the 1st and 3rd day after operation. The concentration of CK-MBN cTnI decreased significantly (P 0.05), and the number of patients treated with positive inotropic drugs and the number of postoperative cardiovascular events were significantly reduced within 3 days after operation (P 0.05). Conclusion Pre-administration of creatine phosphate sodium can alleviate myocardial ischemia-reperfusion injury and improve prognosis in patients with type 2 diabetes mellitus.
【作者单位】：安徽医科大学第一附属医院麻醉科;
【分类号】：R587.1
【正文快照】： 糖尿病是缺血性心脏病的独立发生因素,能够显著增加心血管疾病的发病率和病死率[1]。目前对1型糖尿病心肌缺血-再灌注损伤的研究日渐增多,舒芬太尼对心肌缺血-再灌注损伤有一定的减轻作用,2型糖尿病因素可能导致这种作用减低[2]。磷酸肌酸钠是心肌和骨骼肌的化学储备能量,用于

【相似文献】