磷酸肌酸对心脏直视手术中缺血心肌的保护作用  

The protective effect of exogenous creatine phosphate on myocardium during open heart surgery

作　　者：姚冰薇[1] 王雁娟[1] 王桂龙[1] 邵耀明[2] 

机构地区：[1]江苏省无锡市人民医院麻醉科,无锡214000 [2]江苏省无锡市人民医院检验科,无锡214000

出　　处：《南通大学学报（医学版）》2008年第5期342-343,346,共3页Journal of Nantong University(Medical sciences)

摘　　要：目的:观察外源性磷酸肌酸(CP)用于心肌保护液,对心脏直视手术缺血期间的心肌保护作用。方法:24例患者分为对照组12例,CP组12例,分别观察两组患者在切皮前(T1),体外循环(CPB)结束后5min(T2)及术后24h(T3)的心肌酶谱的变化,肌钙蛋白(cTnI)与肌红蛋白(MB)的定性分析及术毕,术后24h正性肌力药物使用量比较。结果:两组患者T2、T3时心肌酶较T1明显升高(P<0.05),但CP组较对照组上升幅度小(P<0.05)。术毕及术后24h正性肌力药物使用量CP组较对照组少(P<0.05)。两组患者的cTnI和MB在T2、T3时虽有阳性结果病例,但阳性率不高,两组间比较差异无统计学意义(P>0.05)。Objective:This study was designed to evaluate the myocardial protective effect of exogenous creatine phosphate(CP) added into cardioplegic solution used during heart surgery.Method:24 patients were divided into control group(n=12) and CP group(n=12).The changes of serum enzymes including AST,LDH,CK,CK-MB,were determined before cutting(T1),5 minutes after CPB(T2),and 24 hours after operation(T3),cTnI and MB were measured,and the positive inotropic drugs admin-istered were determined after the surgery.Results:There was no statistical significance betweeen the enzymes before operation in two groups.The amputudas of elevation of serum myocardial enzymes in CP group were lower than those in control group.The requirement of inotropic drugs was less in group CP than that in control group.There were no differences in value of cTnI and MB between two groups.Conclusion:CP can provide energy for myocardial cells,protect the cell membrane integrity.It also shows that CP can relieve the ischemia/reperfusion injury.

关 键 词：磷酸肌酸 心肌保护 心脏直视手术 

分 类 号：R614.1[医药卫生—麻醉学]