1,6二磷酸果糖后处理对心脏瓣膜置换术患者围术期心肌酶谱的影响  

Effect of Fructose-1,6-diphosphate Postconditioning on Serum Myocardial Enzymes in Perioperative Cardiac Valve Replacement Patients

作　　者：杨东林[1] 王建斌[1] 冉珂[1] 王丹[1] 常业恬[1] 

机构地区：[1]中南大学湘雅二医院麻醉科,长沙410011

出　　处：《中国现代手术学杂志》2011年第4期300-302,共3页Chinese Journal of Modern Operative Surgery

基　　金：湖南省科技厅项目(2009JT3018)

摘　　要：目的观察1,6二磷酸果糖(FDP)后处理对心脏瓣膜置换术患者围术期心肌酶谱的影响。方法 30例择期心脏瓣膜置换术患者随机分为1,6二磷酸果糖后处理组(F组)和对照组(C组),每组15例。于主动脉开放即刻从体外循环机内F组加入250 mg/kg的FDP,C组加入等容积的生理盐水。于切皮即刻(T1),主动脉开放后0.5 h(T2),主动脉开放后3 h(T3),主动脉开放后24 h(T4)时取颈内静脉血测定肌酸激酶(CK)、肌酸激酶-同功酶(CK-MB)、乳酸脱氢酶(LDH)的浓度变化。结果与T1比较,两组CK、CK-MB和LDH含量在T2、T3、T4时均升高(P<0.05),且在T3时达到峰值(P<0.05);与C组比较,F组在T2、T3、T4时CK、CK-MB和LDH含量均降低(P<0.05)。结论 FDP后处理对瓣膜置换术病人的缺血再灌注心肌有保护作用。Objective To investigate the protective effect of fructose-1, 6-diphosphate （FDP） postconditioning on serum myocardial enzymes in perioperative patients undergoing cardiac valve replacement. Methods Thirty patients were randomly divided into control group and FDP group, 15 in each group. FDP 250 mg/kg was infused from the cardiopulmonary bypass machine just on the time of arteriae aorta opening in FDF group, while physiologic saline with the same volume was given instead of FDP in control group. Blood samples were taken to determine the concentration of CK, CK-MB and LDH on the time of immediately after the skin incision （ T1 ）, 0. 5 h after aortic opening （T2）, 3 h after aortic opening （33）, 24 h after aortic opening （T4）. Results In both two groups, the concentrations of CK, CK-MB and LDH at T2,T3,and T4 were higher than those at T1, and the peak of concentration in these groups was at T3（P 〈0.05）. The concentrations of CK, CK-MB and LDH of FDP group were significantly lower than those of control group at T2, T3 and T4 （P 〈 0.05 ）. Conclusion FDP postconditioning has a protective effect on myocardial ischemiareperfusion injury in the cardiac valve replacement patients.

关 键 词：1  6二磷酸果糖 心脏瓣膜假体植入 心肌保护 

分 类 号：R654.2[医药卫生—外科学]