前列地尔含血停搏液在体外循环中的心肌保护作用  

Protective effect of blood cardioplegia with Lipo-PGE1 on myocardiim during cardiac valve replacement under cardiopulmulnary bypass

作　　者：郁大江[1] 秦建伟[1] 邵永丰[1] 张憬[1] 梁永年[1] 李芝[1] 

机构地区：[1]南京医科大学第一附属医院心胸外科,210029

出　　处：《江苏医药》2009年第5期521-523,共3页Jiangsu Medical Journal

摘　　要：目的探讨心脏含血停搏液加入前列地尔脂微球制剂(Lipo-PGE1)在心肺转流(CPB)心内直视术中的心肌保护作用。方法32例心脏瓣膜置换术患者随机分为两组(每组16例)。B组在心脏含血停搏液中加入Lipo-PGE1 0.5μg/kg;A组单用心脏含血停搏液作为对照。两组分别于CPB前(T0)和主动脉开放后2(T1)、6(T2)、16(T3)h采集桡动脉血,测定血清肌酸激酶同功酶(CK-MB)、肌钙蛋白I(cTnI);观察心脏停跳及复跳情况、术后机械通气时间及术后正性肌力药物的应用情况。结果两组术后CK-MB、cTnI较术前显著升高(P<0.05);与A组相比,B组术后多巴胺用量显著减少(P<0.05),T2时的CK-MB及T2、T3时的cTnI显著降低(P<0.05)。结论Lipo-PGE1加入心停搏液中能显著提高心肌保护的效果。Objective To observe the protective effect of blood cardioplegia with liposomal prostaglandin E1（Lipo-PGE1） on myocardiim during cardiac valve replacement under cardiopulmulnary bypass（CPB）. Methods Thirty-two patients undergoing cardiac valve replacement were randomized into two groups with 16 cases each. The patients in group B were given Lipo-PGE1 0.5μg/kg in cardioplegia solution and those in group A were not aS the controls. Blood samples were taken for measurements of creatine kinase isozyme （CK-MB） and calcitonin-I （cTnI） before CPB （T0）,at 2 h （T1）, 6 h （T2） and 16 h （T3） after aortic declamping. Arrest time, spontaneous resuscitation rate, the requirement for inotropics and intubation time were recorded as well. Results The requirement for inotropies in group B was significantly less than that in group A. The serum levels of cTnI at T2 and T3 and CK-MB at T2 were significantly lower in group B than those in group A. Conclusion Blood cardioplegia solution with Lipo-PGE1 has an effective myocardial protection during cardiac valve replacement under CPB.

关 键 词：前列地尔 心脏含血停搏液 心肺转流 心肌保护 

分 类 号：R654[医药卫生—外科学]