体外循环过程中前列腺素E_1的心肌保护作用  

Function of Prostaglandin E_1 for myocardial protection in cardiopulmonary bypass

作　　者：焦齐[1] 孙志钢[1] 李世珍[1] 杨长征[1] 

机构地区：[1]济南市中心医院心外科

出　　处：《中国心血管病研究》2006年第9期683-685,共3页Chinese Journal of Cardiovascular Research

摘　　要：目的探讨间断冷血灌注过程中前列腺素E(1PGE1)的心肌保护作用。方法选取瓣膜置换手术患者60例,随机分为试验组和对照组,每组30例。两组患者术前心功能、年龄、体重差异均无统计学意义。试验组按PGE1200!g/500ml加入含钾晶体停跳液中,随冷血一并灌注心肌保护,对照组不加PGE1。两组患者均于主动脉阻断前,主动脉开放即刻,开放后2h,术后6h、12h、24h等6个时点采取抗凝动脉血5ml,检测血清心肌肌钙蛋白I(cTnI)含量、SOD活性和MDA含量。结果①cTnI含量检测结果组间比较转流前及主动脉开放即刻差异无统计学意义(P>0.05),术后12h、24h差异有统计学意义(P<0.01),术后2h、6h两组间差异有统计学意义(P<0.05)。组内比较主动脉开放即刻cTnI显著增高(P<0.05),术后2h与转机前比较差异有统计学意义(P<0.01),术后24h达峰值。②SOD活性两组间SOD水平比较转流前差异无统计学意义(P>0.05),主动脉开放2h、6h、12h、24h各时点差异有统计学意义(P<0.01)。术后2h最低。组内比较,主动脉开放后各时点与转机前比较差异有统计学意义(P<0.01)。③MDA含量两组间转机前差异无统计学意义(P>0.05),主动脉开放即刻,术后2h、6h、12h、24h各时点差异有统计学意义(P<0.01)。组内比较主动脉开放后各时点较转机前差异有统计学意义(P<0.01)。结论间断冷血灌注过程中PGE1具有对抗缺血再灌注损伤,明显保护心肌的作用。Objective This study is designed to approve the function of PGEt in cold blood cardioplegia for myocardial protection. Methods 60 patients who underwent valve replacement operation were selected and randomly divided into two groups：group of experiment （group Ⅰ ） and group of comparison （group Ⅱ ）. PGE1 was mixed into the crystalloid cardioplegia according to the dose of 200 μg/500 ml and affused with cold blood in group Ⅰ . Blood example was taken to assess myocardial troponin I（cTnI）, superoxidedisemutase（SOD ） and malondialdehyde （MDA） at the time before aorta clamped, the moment of aortic unclamp, 2 hours, 6 hours, 12 hours and 24 hours after operation. Results and Conclusion Plasma levels of cTnl and MDA in group Ⅰ were remarkably lower than that in group Ⅱ , SOD was remarkably higher in group Ⅰ than that in group Ⅱ . Result of the study indicate that PGE1 could abate Ischemia-Reperfusion injury and enhance the effect of myocardial protection. Function of PGE1 for cardioprotection is related with its character of abate the superoxide reaction of lipid, control the adhesive of PMN, control the mass of blood platelet.

关 键 词：前列腺素E类 心肌再灌注损伤 心肺转流术 

分 类 号：R654.1[医药卫生—外科学]