瑞芬太尼预处理对非体外循环冠脉搭桥术患者血浆肌钙蛋白Ⅰ的影响  

Remifentanil preconditioning lowers cardiac troponin Ⅰ levels in patients undergoing off-pump coronary artery bypass graft surgery

作　　者：徐忠东[1] 金沐[2] 何伟雄[3] 夏淑轩[1] 赵一凡[1] 何波[1] 曹德雄[1] 彭书崚[1] 李珏[1] 曹铭辉[1] 

机构地区：[1]中山大学附属第二医院麻醉科,广东广州510120 [2]中国医学科学院/中国协和医科大学阜外心血管病医院麻醉科,北京100037 [3]中山大学附属肿瘤医院麻醉科,广东广州510060

出　　处：《南方医科大学学报》2009年第8期1554-1556,共3页Journal of Southern Medical University

基　　金：广东省科技计划项目(2007B030704005;2007B031500002)

摘　　要：目的应用心肌肌钙蛋白I(cTnI)评价瑞芬太尼预处理对非体外偱环冠脉搭桥(OPCAB)患者的心肌保护作用。方法选择24例行OPCAB的冠心病患者,随机分为瑞芬太尼预处理组(R组)和对照组(C组)。所有患者术前口服安定10mg,肌肉注射吗啡10mg、东莨菪碱0.3mg,全麻诱导静脉注射咪唑安定0.08mg/kg,依托咪酯0.1~0.3mg/kg,芬太尼5~10μg/kg,罗库溴铵1mg/kg诱导,吸入1MAC异氟醚,持续静脉输注异丙酚0.8~2μg/ml;间断给予芬太尼5~10μg/kg,哌库溴铵0.05mg/kg。R组:瑞芬太尼5μg/kg溶于50ml生理盐水,于麻醉诱导后10min恒速泵完。C组:泵注同等容量生理盐水。测定术前、术毕及术后1、6、24、48h血浆cTnI水平。结果各组内术后cTnI水平均明显增高(P<0.05)。R组术后cTnI水平显著低于C组(P<0.05)。结论瑞芬太尼预处理可降低OPCAB患者的cTnI水平,减轻心肌损伤。Objective To investigate the value of cardiac troponin I (cTnI) levels in assessing myocardial protection by remifentanil precondition against myocardial injury induced by off-pump coronary artery bypass (OPCAB). Methods Twenty-four patients undergoing OPCAB were randomized into control and remifentanil preconditioning group (n=12). All the patients received pretreatment with oral diazepam (10 mg), intramuscular morphine (10 mg) and hyosine (0.3 mg). General anesthesia was induced with midazolam (0.08 mg/kg...

关 键 词：心肌肌钙蛋白I 瑞芬太尼 非体外偱环冠状动脉旁路移植术 缺血预处理 心肌再灌注损伤 

分 类 号：R614[医药卫生—麻醉学]