盐酸戊乙奎醚对心脏瓣膜置换术患者心肌缺血再灌注损伤的保护作用  

Effect of penehyclidine on myocardial ischemia-reperfusion injury in patients undergoing valve replacement

作　　者：刘流[1] 周海洋[1] 王建斌[1] 吕志平[1] 

机构地区：[1]中南大学湘雅二医院麻醉科,长沙410011

出　　处：《中国新药杂志》2010年第15期1351-1354,共4页Chinese Journal of New Drugs

基　　金：湖南省科学技术基金项目(2009JT3018)

摘　　要：目的:观察盐酸戊乙奎醚对心脏瓣膜置换术患者心肌缺血再灌注损伤的保护作用。方法:60例择期心瓣膜置换术患者分为盐酸戊乙奎醚2mg组(I组)、4mg组(Ⅱ组)和对照组(Ⅲ组),每组20例,Ⅰ,Ⅱ组患者术前用药为盐酸戊乙奎醚0.03mg.kg-1肌注,转流前20min用盐酸戊乙奎醚2mg静注,心肺转流前20min用盐酸戊乙奎醚4mg静注,III组术前用药为东莨蓉碱0.03mg.kg-1肌注,转流前20min用等量生理盐水静注。在转流前(T0),开放主动脉后30min(T1),1h(T2),2h(T3),12h(T4),24h(T5)抽取桡动脉血测过氧化脂质(MDA)、细胞炎性因子TNF-α,IL-6,IL-10和心肌肌钙蛋白I(cTnI)。结果:I,Ⅱ组与III组比较:MDA明显减少(P<0.05);TNF-α,IL-6含量明显降低(P<0.05),IL-10明显升高(P<0.05);cTn1含量明显降低(P<0.05);I组与II组同时值比较:TNF-α,IL-6明显升高(P<0.05),IL-10明显降低(P<0.05),T3,T4时cTnI明显升高(P<0.05),T1,T2时MDA明显升高(P<0.05)。结论:盐酸戊乙奎醚可明显减轻心脏瓣膜置换术患者心肌缺血再灌注后脂质过氧化和过度的炎性反应,减轻心肌受损程度,在一定的剂量范围内加大剂量,其心肌保护作用增强。Objective ： To investigate the protective effect of penehyclidine on myocardial ischemia-reperfusion injury in patients undergoing vale replacement. Methods： Sixty patien groups （ n = 20 in each group）. Penehyclidine or scopolamine 0.03 mg· kg^-1 operation, and then 2 or 4 mg was intravenously infused 20 min before CPB. B the concentration of MDA, TNF-α, IL-6, IL-10 and cTnI before CPB （T0） ts were randomly div was intramuscularly lood samples were tak and 30 min （T1）, （ T3 ） , 12 h （T4） , 24 h （ T5 ） after aortic declamping. Results ： penehyclidine can ameliorate myoc ided into three injected before en to determine 1 h（T2）, 2 h ardial ischemia reperfusion injun by modulate inflammatory response.

关 键 词：盐酸戊乙奎醚 心脏瓣膜置换 心肌保护 

分 类 号：R971.2[医药卫生—药品]