左西孟旦对二尖瓣置换术中心肌缺血—再灌注损伤的保护作用

发布时间：2018-05-08 22:19

本文选题：二尖瓣置换术 + 左西孟旦　；参考：《延边大学》2014年硕士论文

【摘要】：目的：探左西孟旦(Levosimendan Injection, LEV)在体外循环下二尖瓣置换术中心肌缺血-再灌注损伤的保护作用。方法：选取延边大学附属医院心血管外科2011年11月至2014年3月风湿性心脏瓣膜病患者28例,随机分为对照组(n=14))和LEV组(n=14),对照组患者术前术中给予常规心肌营养,左西孟旦组患者在麻醉诱导前左西孟旦注射液0.2ug/kg/min持续24h静脉给药,分别于术前(T1)、术毕(T2)、术后24h(T3)、术后7d(T4)抽取患者静脉血,检测血浆乳酸脱氢酶(lactate dehydrogenase, LDH),肌酸激酶(Creatine Kinase, CK),肌酸激酶同工酶(Creatine Kinase-MB, CK-MB),心肌肌钙蛋白I (Cardiac Troponin I, cTnI),并记录患者术前及术后7d左室射血分数(left ventricular ejection fraction, LVEF)。结果：与对照组相比,给药组T2、T3、T4血浆LDH, cTnI浓度明显低于T1(P0.01,P0.05),T2、T3血浆CK、CK-MB浓度均明显低于T1(P0.01,P0.05),T4无明显统计学差异(P0.05)。对照组术前与术后相比LVEF无明显差异(P0.05),给药组LVEF较术前升高(P0.05)。结论：1.左西孟旦注射液对二尖瓣置换术后患者具有降低心肌酶学指标和cTnI水平,有效地提高左室射血分数作用。 2.左西孟旦注射液可减轻心脏瓣膜置换术中的心肌缺血-再灌注损伤,对心肌具有保护性作用。
[Abstract]:Aim: to investigate the protective effect of Levosimendan injection (Levo simendan injection) on myocardial ischemia-reperfusion injury during mitral valve replacement under cardiopulmonary bypass (CPB). Methods: from November 2011 to March 2014, 28 patients with rheumatic heart valve disease were randomly divided into two groups: control group (n = 14) and LEV group (n = 14). The patients in control group were given routine myocardial nutrition before operation. The patients in the levosimendan group received 0.2ug/kg/min for 24 hours before anesthesia induction. Venous blood was extracted from the patients with T1, T2, T3, and T4 at 24 hours after operation, 7 days after operation, respectively, before anesthesia induction, the patients were given intravenous administration of levsimendan injection for 24 hours before anesthesia induction, and the patients were given intravenous administration of levsimendan injection for 24 hours before anesthesia induction. Plasma lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MBP), cardiac troponin I cardiac Troponin I (cTnI), left ventricular ejection fraction (LVEF) were measured before and 7 days after operation. Results: Compared with the control group, the plasma LDHs and cTnI concentrations in the administration group were significantly lower than those in the T1P0.01P0.05T2T3 and T1P0.01P0.05T4 groups. There was no significant difference between the two groups (P 0.05). There was no significant difference in LVEF before and after operation in the control group (P 0.05). The LVEF in the administration group was significantly higher than that in the preoperative group (P 0.05). Conclusion 1. Levosimendan injection can decrease myocardial enzyme index and cTnI level and increase left ventricular ejection fraction (LVEF) after mitral valve replacement. 2. Levosimendan injection can reduce myocardial ischemia-reperfusion injury in cardiac valve replacement and has protective effect on myocardium.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R654.2

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