体外循环下心肌缺血再灌注后血清心肌酶、SOD活性变化及复方丹参的应用  

Variation of serum myocardial enzymes and superoxide dismutase levels following myocardial ischemia and reperfusion in patients undergoing CPB and the application of Salvia miltiorrhiza compound

作　　者：夏正远[1] 顾家珍[1] 张遵严[1] 翟中云[2] 余金甫[1] 黄海波[1] 胡岚[1] 

机构地区：[1]湖北医科大学附属一院,武汉市430060 [2]湖北江汉油田中心医院麻醉科

出　　处：《中华麻醉学杂志》1996年第4期153-155,共3页Chinese Journal of Anesthesiology

摘　　要：20例先天性室间隔或房间隔缺损患者,ASAⅡ～Ⅲ级,麻醉后随机分为两组,组Ⅰ为对照组(n=10),组Ⅱ为复方丹参治疗组(n=10)。组Ⅱ于手术开始前及复温后心脏复跳前分别静脉注射复方丹参200mg/kg。结果表明,组Ⅰ缺血(T_2)及再灌注后各期血清乳酸脱氢酶(LDH)、肌酸激酶(CK)与术前(T_0)比较显著增高,而超氧化物岐化酶(SOD)明显下降,与组Ⅱ各时期值有显著差异,且术后心功能恢复较组Ⅱ差。组ⅡT_2时LDH、CK及SOD与T_0比较无明显差异,再灌注30分钟LDH、CK才有明显上升,但显著低于组Ⅰ(P<0.01),组Ⅱ再灌注后SOD无明显降低。本试验结果显示:复方丹参能明显降低心内直视手术患者血清LDH、CK活性,促进缺血再灌注心肌功能的恢复。The serum lactic dehydrogenase (LDH),creatine kinase (CK) and superoxide dismutase (SOD) activities and the effects of Salvia miltiorrhiza compound (SMC) on them were observed in patients with CPB during perioperation. Twenty patients,aged 2～41 years, ASA grade Ⅱ-Ⅲ, scheduled for elective cardiac surgery,were randomly divided into control group (group C, n=10). and test group (group T,n=10). SMC at a dosage of 200mg/kg was given intravenously in group T before onset of operation and at the time of rewarming respectively,and equivalent volumes of normal saline were administered in group C. The central venous blood samples were collected to measure the serum concentrations of LDH,CK and SOD by biochemical methods. The serum LDH and CK levels increased significantly in group C,and the SOD level decreased markedly following ischemia and reperfusion (P<0.05 or 0.01). In group T,the serum LDH,CK and SOD values changed unsignificantly during ischemia,and SOD level did not vary dramatically following reperfusion,and those of LDH and CK did not increase until 30 mins following reperfusion. The above values mentioned were lower at corresponding times in group T than those in group C (P<0.05). The postoperative cardiac function recovered much more better in group T than in group C. It is indicated that SMC can reduce the degree of myocardial damage during CPB,and the mechanism may be related to its action of reducing lipid peroxidation.

关 键 词：复方丹参液 心内直视手术 心肌缺血 再灌注损伤 

分 类 号：R654.2[医药卫生—外科学] R286.2[医药卫生—临床医学]