三磷酸腺苷对心脏不停跳心内直视术中心肌保护作用的研究  

Myocardial protective effects of ATP precondition in cardiac patient with beating heart surgery during cardiopulmonary bypass

作　　者：边虹[1] 郭德和[1] 韩育宁[1] 苏金林[1] 

机构地区：[1]宁夏医学院附属医院,宁夏银川750001

出　　处：《宁夏医学杂志》2008年第1期11-12,共2页Ningxia Medical Journal

摘　　要：目的探讨三磷酸腺苷在心脏不停跳心内直视手术体外循环期间的心肌保护作用及临床效果。方法将30例心脏不停跳心内直视手术先天性心脏病患者,随机分为两组。实验组15例,于麻醉诱导后转机前给予三磷酸腺苷,用量160μg/kg,以WZ-50C6微量泵输入,5ml/h,10分钟输完。对照组按常规处理。分别在术前、转机后30分钟及术后6、12小时各时间点抽取桡动脉血3ml,测定心肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB),并记录CPB转机时间、心律失常发生率、ICU监护时间以及围CPB期间心血管活性药物的使用情况。结果实验组心肌损伤的指标心肌钙蛋白I(cTnI)及肌酸激酶同工酶(CK-MB)升高梯度低于对照组。实验组CPB转机时间、ICU监护时间、心律失常发生率以及围CPB期间心血管活性药物的使用均少于对照组。结论三磷酸腺苷对不停跳心内直视手病人有一定的心肌保护作用。Objective To investigate myocardial protective effects of ATP precondition in beating heart surgery during cardiopulmonary bypass. Methods 30 patients scheduling for beating heart surgery were randomly divided into experiment group and control group. ATP preconditioning was performed in experiment group before cardiopulmonary bypass. The blood sample was taken before operation, 30 minute after cardiopulmonary bypass beginning, 6 hour and 12 hour after the end of cardiopalmonary bypass and plasma level of cardiotropenin I （cTnI） creatine kinase isoenzyme （CK -MB） was measured. Meanwhile the time of cardiopulmonary bypass, the time cared in ICU, the rate of arrhythmia and cardiac inotropic agents and its duration were recorded. Results The elevated range of plasm cTnI and CK - MB in experiment group was significantly lower than that in control group. In experiment group, the time cared in ICU, the rate of arrhythmia and cardiac inotropic agents and its duration were lower than those in control group. Conclusion ATP precondition has notable clinical、protective effects in beating heart surgery during cardiopulmonary bypass.

关 键 词：心脏不停跳心内直视手术 三磷酸腺苷 心肌保护 

分 类 号：R654.2[医药卫生—外科学]