联合应用贝那普利与丙泊酚对体外循环下冠脉搭桥术患者心肌缺血再灌注损伤的影响

发布时间：2018-07-04 09:28

本文选题：丙泊酚 + 贝那普利　；参考：《中国老年学杂志》2015年19期

【摘要】：目的观察丙泊酚联合贝那普利预处理对体外循环下冠脉搭桥术患者心肌缺血再灌注损伤的保护作用。方法体外循环下行冠脉搭桥术患者100例,分为丙泊酚组和丙泊酚贝那普利联合组,丙泊酚组患者及在术中使用丙泊酚持续泵入麻醉,联合组患者在术前1 w服用贝那普利,术中持续泵入丙泊酚麻醉,监测麻醉前、术后6 h、12 h、24 h、72 h肌酸激酶同工酶的活性和心肌肌钙蛋白浓度。观察并记录术后12、24、48 h正性肌力药使用情况,术前、术后左室射血分数、心肌缺血发生情况、自动复跳情况。结果两组患者术前肌酸激酶同工酶和心肌肌钙蛋白浓度无统计学差异,术后各观察时间点联合组肌酸激酶同工酶和肌钙蛋白浓度比丙泊酚组低,正性肌力药使用少,自动复跳率及左室射血分数高。结论术前服用贝那普利、术中丙泊酚靶控输注比只在术中丙泊酚靶控输注更能减轻体外循环下冠脉搭桥术患者的心肌炎性反应,保护缺血再灌注心肌。
[Abstract]:Objective to observe the protective effect of propofol combined with benazepril on myocardial ischemia reperfusion injury in patients undergoing coronary artery bypass grafting. Methods 100 patients undergoing coronary artery bypass grafting under cardiopulmonary bypass were divided into propofol group and propofol benazepril group. Continuous infusion of propofol was performed during the operation. The activity of creatine kinase isoenzyme and cardiac troponin concentration were monitored 6 h after anesthesia and 24 h at 24 h after anesthesia. To observe and record the use of positive inotropic drugs at 24 hours after operation, to observe and record the left ventricular ejection fraction (LVEF), myocardial ischemia and automatic resuscitation before and after operation. Results there was no significant difference in serum creatine kinase isoenzyme and cardiac troponin concentration between the two groups before operation. The concentration of creatine kinase isoenzyme and troponin in the combined group was lower than that in the propofol group, and the positive inotropic drugs were used less in the combined group than in the propofol group. Automatic resuscitation rate and left ventricular ejection fraction were high. Conclusion the target-controlled infusion of propofol before operation is more effective in alleviating the myocarditis response of patients undergoing coronary artery bypass grafting than in only using propofol during the operation, and can protect the myocardium from ischemia and reperfusion.
【作者单位】：邢台市人民医院;
【基金】：邢台市科技支撑计划项目(2014ZC168)
【分类号】：R614.2

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