硝酸甘油对冠心病病人围术期心肌肌钙蛋白Ⅰ的影响  

Effects of nitroglycerin on cardiac troponin Ⅰ in coronary heart disease patients undergoing non-cardiac surgery

作　　者：方传奇[1] 王存真[1] 李建中[1] 高冰[1] 

机构地区：[1]河南省商丘市第一人民医院麻醉科,商丘476100

出　　处：《中原医刊》2006年第24期25-26,共2页Central Plains Medical Journal

摘　　要：目的研究硝酸甘油对冠心病病人围术期心肌肌钙蛋白Ⅰ（cTnⅠ）的影响，以观察其心肌保护作用。方法60例行上腹部手术的冠心病病人，ASAⅡ-Ⅲ级，随机分为对照组（C组）和硝酸甘油组（N组）。分别测定患者诱导前、诱导后6h，诱导后16h的cTnⅠ浓度，并统计心电学变化状况，心脏事件发生率。结果两组患者cTnⅠ浓度及阳性率均升高，但N组小于C组（P〈0．05，P〈0．01），与C组比较，N组心电变化，心脏事件发生率均低于C组（P〈0．05）。结论硝酸甘油可明显缓解冠心病病人围术期cTnⅠ上升程度，减少心电学变化及心脏事件发生率，保护心肌。Objective To investigate the effects of nitroglycerin on cardiac troponin Ⅰ （cTn Ⅰ ）in coronary heart disease patients during non - cardiac surgery. Methods Sixty patients with coronary heart disease undergoing selective upper abdominal surgery, ASA Ⅱ or Ⅲ, were randomly divided into control group （ group C, n = 30）and nitroglycerin group （group N, n = 30）. Venous blood samples were taken before induction of anesthesin（ T0 ） at 6h （T1 ） and 16h（ T2 ） after induction of anesthesia. The concentrations of cTn Ⅰ were analyzed by immunoassay. Meanwhile, the rate of ECG change and cardiac events were recorded. Results Concentrations of cTn Ⅰ was increased at T1 and T2 in both groups compared with To, but cTn Ⅰ in group C was significantly higher than that in group N （ P 〈 0. 05, P 〈 0. 01 ）. The rate of ECG change and cardiac events of group C was markedly more than that of group N （ P 〈 0. 05）. Conclusion Continuous infusion of nitroglycerin may result in good heart protection with less increase of cTn Ⅰ , ECG change and cardiac events.

关 键 词：硝酸甘油 冠心痛 心肌肌钙蛋白Ⅰ 

分 类 号：R541.4[医药卫生—心血管疾病] R619[医药卫生—内科学]