山莨菪碱对体外循环期间心脏迷走神经变化的影响  

The influence of anisodamine(654-2) on cardiac vagus activity in patients undergoing open heart surgery with cardiopulmonary bypass

作　　者：王延明[1] 王艳军[1] 张国平[1] 李庆周 臧玉林[1] 宋宇宏[1] 李险波[1] 

机构地区：[1]中国人民解放军252医院胸心外科,071000

出　　处：《河北医药》1999年第5期327-328,共2页Hebei Medical Journal

摘　　要：目的：探讨先天性心脏病患者体外循环（CPB）期间心脏迷走神经变化对心肌再灌注损伤的影响，并阐明迷走神经拮抗剂-山莨菪碱（654-2）的心肌保护作用。方法：58例先心病患者随机均分为两组：使用常规心肌保护液为对照组，在常规心肌保护液中加入654-20．5ing／kg为用药组，分别测定不同手术时期两组冠状窦血中乙酰胆碱（Ach）、Ca2+及过氧化脂质（Lpo）含量，经Swan－Ganz导管测定心排量（CO）变化。结果：再灌注时及转流后对照组冠状赛血中彻Ach、Ca2+和Lpo含量明显增高（P＜0．o1，P＜0．001），与用药组比较具有显著性差异（P＜0．05，P＜0．o1）；转流后用药组的心排量稍有增加，但与对照组比较也有显著性差异（P＜0．01）。结论：Ach在CPB再灌注期间释放增多，在心肌停跳液中加入654－2可抑制迷走神经活动，增加心排血量，从而有效地防治心肌再灌注损伤，保护心脏功能。Objcctive:To clucidatc the influencc of cardiac vagus activity on myocardial rcperfu-sion injury and 654-2 on the effect of mypeardial protection. Methods: fifty eight patients undcrgoingopen heart surgery wcre randomly divided into two groups, contro group(n = 29, crytalloid cardio-plcgia solution)and trcatment group(n = 29, control + 654-2 0. 5mg/kg). Cardiopulmonary bypass(CPB) was carricd out routinely. Swan-Ganz catheter was inserted into pulm0nary artery in all pa-ticnts and cardiac out put(CO) was meassured by thcrmodilution mcthod. Blood samples were takenfrom coronary sinus before CPB, after release of aortic cross-clamping and immdiately after stop CPBfor determination of acetylcholine(Ach), Ca2 + and lipidptroxide(LPO). Rcsults: The content of Ach,Ca2+ and Lpo in control group were increasod significantly. A notable incrcasc of CO was also ob-scrved after stop CPB in teatment group in compared with control group(P < O. 01 ). Conclusion:There was incrcased of Ach during reperfusion. The results indicate that 654-2 may increase of COand play an important roe in thc prevention of myocardial reperfusion injury, during open heart poera-tiove patients with CPB.

关 键 词：体外循环 迷走神经活动 心排血量 山莨菪碱 

分 类 号：R654.1[医药卫生—外科学]