丹参酮ⅡA磺酸钠在体外循环心脏直视术中缺血早期心肌保护作用及对IMA、GPBB水平的影响  

Myocardial protective effect of Tanshinone ⅡA sodium injection in open heart surgery during cardiopulmonary bypass myocardium and the effect on the levels of IMA and GPBB

作　　者：豆利华[1] 

机构地区：[1]河北省邢台市人民医院临床药学室,054001

出　　处：《河北医药》2010年第17期2327-2329,共3页Hebei Medical Journal

摘　　要：目的研究丹参酮ⅡA磺酸钠在体外循环心脏直视术中缺血早期(6h内)心肌保护作用及缺血性修饰白蛋白(IMA)、糖原磷酸化酶同工酶BB(GPBB)水平的影响。方法选取风湿性心脏病体外循环下二尖瓣置换术患者60例,随机分为治疗组(Ⅰ组)和对照组(Ⅱ组),每组30例。2组灌注方法及体外循环方法相同。治疗组于手术开始前给予丹参酮ⅡA磺酸钠注射液80mg加入25%葡萄糖注射液20ml静脉注射,对照组给予等容量的平衡液。分别于手术前(T1)、主动脉开放后30min(T2)、2h(T3)、6h(T4)、12h(T5)、24h(T6),采集患者静脉血,测定IMA、GPBB、磷酸肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)并进行组间比较及以上指标在血中出现时间和趋势比较。结果 2组患者在主动脉开放后30min白蛋白钴离子结合试验(ACB)值已达峰值,而后呈上升趋势,主动脉开放后24h基本恢复正常,治疗组ACB值明显高于对照组(P<0.01);GPBB于主动脉开放后2h出现,6h达峰值,其后呈下降趋势,于24h基本恢复正常;CK-MB、cTnI于主动脉开放后6h出现,其后呈上升趋势。治疗组于主动脉开放后2、6、12、24hGPBB、CK-MB、cTnI浓度均明显低于对照组,差异有统计学意义(P<0.05)。结论丹参酮ⅡA磺酸钠在体外循环心脏直视术中心肌缺血早期能够有效起到心肌保护作用及以IMA、GPBB为检测指标能更好的反映其早期的心肌保护作用。Objective To investigate the myocardial protective effect of Tanshinone IIA sodium injection in open heart surgery under extracorporeal circulation and the effect on the levels of IMA and GPBB.Methods 36 patients with rheumatic heart disease undergoing mitral valve replacement under cardiopulmonary bypass were randomly divided into treatment group （n=30） and control group （n=30）,perfusion and cardiopulmonary bypass were performed for two groups in the same way.The patients in treatment group were administrated with Tanshinone IIA sodium injection 80mg in 20ml of 25% intravenous glucose injection before operation,however,the patients in control group were treated with balance solution.The patients’ venous blood was collected at 30min,2h,6h,12h,and 24h after aorta opening.The levels of IMA,GPBB,CK-MB and cTnI were detected to observe the emergence time and tendency of these parameters between the two groups.Results ACB data arrived the peak at 30min after aorta opening and showed upgrade tendency,recovered to normal level at 24h after opening.The ACB levels of treatment group were significantly higher than that of control group（P0.01）.GPBB appeared at 2h after opening,arrived the peak at 6h,appeared downgrade tendency and recovered to normal level at 24h.CK-MB and cTnI appeared at 6h after opening and showed upgrade tendency.The levels of GPBB,CK-MB,cTnI in treatment group were obviously lower than those of control group at 2h,6h,12h and 24h after opening （P0.05）.Conclusion The sodium tanshinone ⅡA sodium injection has an effective protective effect on myocardium at early period of myocardial ischemia in cardiopulmonary bypass heart surgery.ACB and GPBB can be used as the indexes that can show preferably the reaction of pristine function of myocardial preservation

关 键 词：丹参酮 缺血早期心肌保护 缺血性修饰白蛋白 糖原磷酸化酶同工酶BB 

分 类 号：R654.1[医药卫生—外科学]