灯盏花素对心肺转流瓣膜置换术患者心肌缺血-再灌注损伤的影响

发布时间：2018-09-18 08:17

【摘要】：目的心肺转流(cardiopulmonary bypass,CPB)瓣膜置换术可诱发心肌缺血-再灌注损伤,影响心功能恢复。文中旨在探讨体外循环前静脉输注灯盏花素对CPB瓣膜置换术患者心肌缺血-再灌注损伤的影响。方法选择河北北方学院附属第一医院2013年5月至2014年7月间40例全身麻醉下行CPB瓣膜置换术患者。采用随机数字表法,将患者随机分为对照组及灯盏花素组,每组20例。麻醉诱导完成后,采用微量泵分别向对照组以及灯盏花素组静脉输注15 m L等渗盐水和剂量为0.75 mg/kg的灯盏花素,30 min内输注完毕。分别于切皮前(T0)、主动脉开放后30 min(T1)、6 h(T2)、12 h(T3)、24 h(T4)5个时间点采集颈内静脉血,测定血清心肌肌钙蛋白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)的浓度。结果与切皮前比较,2组主动脉开放后30min、6 h的c Tn I和CK-MB浓度均明显升高(P0.05),在T2时达峰值,而SOD活性均明显下降(P0.05)。与对照组比较,T1-T4时灯盏花素组c Tn I和CK-MB浓度明显降低,SOD浓度明显升高(P0.05)。结论体外循环前静脉输注灯盏花素可减轻CPB下瓣膜置换术患者心肌缺血-再灌注损伤,推测其机制与抗氧化应激作用有关。
[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.
【作者单位】：河北北方学院研究生学院;河北北方学院附属第一医院麻醉科;
【分类号】：R654.2

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