心肌肽素在复杂先心病根治术中对心肌保护作用的临床研究  

The study of cardiomyoprotective role with cardiomyopeptide in complicated congenital heart disease operation

作　　者：邱立成[1] 石海燕[1] 王奇[1] 王立新[1] 薛炎[1] 周小英[1] 

机构地区：[1]武警总医院心血管外科,北京100039

出　　处：《中国医药导报》2008年第4期11-13,共3页China Medical Herald

摘　　要：目的:观察心肌肽素(cardiomyopeptide)在复杂先心病根治术中对心肌的保护作用。方法:63例复杂先天性心脏病患者,其中,法乐氏四联症(TOF)43例,右室双出口(DORV)11例,完全性心内膜垫缺损(C-ECD)9例,同期行根治术。患者随机分为两组,心肌肽素治疗组术中给予3mg/kg、术后以3mg/kg连用3d,对照组给予GIK液(10%葡萄糖200ml+50%葡萄糖100ml+普通胰岛素10U),给予时间与治疗组相同。两组分别于主动脉阻断前,复灌后6,12,24,48,72h采集患者中心静脉血,测心肌酶学:磷酸肌酸激酶(CK)、磷酸肌酸激酶同工酶(CK-MB)、心肌钙蛋白I(cTn-I)含量。统计数据分析用SPSS11.5,计量资料以均数±标准差(x±s)表示,组间、组内手术前后比较用配对t检验,计数资料以百分率表示,采用行χ2检验。结果:心肌肽素治疗组心脏自动复搏率较对照组高,术后多巴胺用量较对照组少,两组术后心肌酶谱、cTn-I均较术前高,两组间术前和术后心肌酶谱无显著性差异,但cTn-I治疗组较与对照组有显著性差异。结论:心肌肽素在阻断时间较长的复杂先心病根治术中可能对心肌起到更明显的保护作用。Objective：To observe cardiomyoprotective role with cardiomyopeptide in complicated congenital heart disease operation.Methods：We observed the 63 cases （male 33 cases, female 30 cases） of patients whose age was from 11 months to 12 year-old with complicated congenital heart disease divided including 43 cases of TOF,1 lcases of DORV,9 cases of C-ECD. They were randomly divided into two groups , cardiomyopeptide treatment group and GIK （10% GS 200ml ＋ 50% GS 100ml ＋ RI 10 U） control group which had been infused in operation and for 3 days postoperation with the dosage of 3mg/kg cardiomyopeptide and routine GIK. The blood samples were obtained before aortic block^at 6,12, 24,48,72h of post-reinfusion, and the myocardial zymogram（CK and CK-MB）,cTn-I.The results were analyzed with the SPSS 11.5. Results： The rate of spontaneous reheating in cardiomyopeptide treatment group was higher than in control one; the dosage of dopamine hydrochloride post-operation in cardiomyopeptide treatment group was lower than in control one;the post-operation levels of CK,CK-MB and cTn-I of both groups were higher than pre-operation ones. The myocardUmase of two groups not significantly different in pre-operation and post-operation,but the cTn-I was significantly different. Cardiomyopeptide may show effective myocardial protection in long-time aortic block of complicated congenital heart disease operation.

关 键 词：心肌肽素 复杂先心病 心肌保护 

分 类 号：R541.1[医药卫生—心血管疾病]