美心力对心脏直视术中心肌缺血/再灌注损伤的保护作用  

The Protective Effect of Cyclic Adenosine Monomphsopate on Myocardial Ischemia-Reperfusion Injury During Open Heart Surgery

作　　者：袁媛[1] 龙村[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京阜外心血管病医院体外循环科,北京100037

出　　处：《中国体外循环杂志》2007年第3期129-131,共3页Chinese Journal of Extracorporeal Circulation

摘　　要：目的研究美心力在体外循环(extracorporeal circulation,ECC)心脏直视术中心肌缺血/再灌注损伤的心肌保护作用。方法择期ECC心脏瓣膜手术患者30例,随机分为对照组和美心力组(实验组)。对照组不给药,实验组将美心力40 mg加入心脏停搏液中。观察诱导停搏时间、心脏复跳情况,分别于麻醉诱导后、再灌注2 h、6h、24 h,取患者静脉血测定样本中下列各指标的水平:肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白I(cTnI)。结果诱导停搏时间实验组较对照组显著减少;自动复跳率实验组(14/15)较对照组(9/15)高,再灌注2 h、6 h、24 h两组CKMB、LDH、cTnI均逐渐升高,但实验组显著低于对照组。结论美心力可以减轻ECC心脏直视术中心肌缺血/再灌注损伤。OBJECTIVE To investigate the protective effect of cyclic adenosine monomphsopate（cAMP）on ischemia-reperfusion injury during open heart surgery under extracorporeal circulation（ECC）.METHODS 30 patients undergoing elective cardiac operation for valve replacement were prospectively randomized into two groups： group M（n=15） receiving cAMP and group C（n=15） not receiving it.The incidence rate of heart spontaneous rebeating,defibrilation,arrhythmia were recorded.Blood samples were withdrawed from central vein for the measurements of CKMB,LDH,cTnI after induction,reperfusion 2 h,6 h and 24 h.RESULTS The ratio of myocardial auto-resuscitation in group M（93.3%）was significantly higher than that in group C（60.0%）.The values of CKMB,LDH and cTnI in M group after ECC were significantly lower than those in group C at different time points（P〈0.05）.CONCLUSION cAMP may significantly protect the myocardial from ischemia-reperfusion injury.

关 键 词：环磷腺苷 心肌缺血 再灌注损伤 体外循环 

分 类 号：R654.2[医药卫生—外科学]