黄芪注射液抗心肌缺血-再灌注损伤的临床研究  

Clinical study of astragalus membranaceus injection on protecting myocardial ischemiareperfusion injury

作　　者：周苏宁 邵伟[2] 张文高 鹿小燕 于素勤 

机构地区：[1]山东中医药大学西医教学部,山东济南250014 [2]山东省千佛山医院麻醉科,山东济南250014 [3]山东省威海市建设集团职工医院,山东威海264200

出　　处：《中国中西医结合急救杂志》2000年第3期168-170,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：山东省自然科学基金!资助项目 ( Q99C0 3 )

摘　　要：目的 :探讨黄芪注射液防治体外循环心内直视手术中心肌缺血再灌注损伤 (MIRI)的作用机制。方法 :将 12例风湿性心脏病瓣膜置换术和先天性心脏病室间隔缺损修补术患者随机分为对照组和治疗组 ,每组6例。治疗组通过锁骨下静脉静注黄芪注射液 40 g;对照组不加中药。检测 2组在不同时间的心肌酶、氧自由基含量 ,一氧化氮 (NO)和一氧化氮合酶 (NOS)活性。结果 :主动脉阻断致心肌缺血及心脏恢复灌注后心肌酶均呈上升趋势 ,除主动脉阻断 10分钟外 ,其余各时间点肌酸激酶及其同工酶 (CK、CK MB)在治疗组均显著低于对照组 (P<0 .0 1或 P<0 .0 5 )。 2组缺血及再灌注各时间点血清超氧化物歧化酶 (SOD)活性下降 ,丙二醛(MDA)含量升高 ,以再灌注 10分钟最为显著 ,与术前比较均有 0 .0 1和 P<0 .0 5 )。 NO在治疗组再灌注 180分钟明显高于对照组 (P<0 .0 5 )。结论 :黄芪注射液可降低 MDA含量 ,提高 SOD活性 ,升高再灌注后 NO及 NOS活力 ,减少心肌酶的释放 ,具有保护 MIRI的作用。Objective:To investigate the mechanism of astragalus membranaceus injection on protecting myocardial ischemiareperfusion injury (MIRI) in open heart surgery under cardiopulmonary bypass.Methods:12 patients with either valvular heart disease or congenital ventricular septal defect were divided randomly into control group and treatment group,six cases in each group.Both groups were undergoing open heart surgery under cardiopulmonary bypass.The treatment group was injected 40 g astragalus membranaceus injection via subclavian,while the control group was not injected traditional Chinese medicine.Myocardial enzyme and oxygen free radical,the activity of nitric oxide(NO),nitric oxide synthase(NOS) in blood sample from via subclavian were measured in both groups at different time after injection.Results:The content of myocardial enzyme in the two groups both presented a tendency to ascend after aorta occluded and released.The content of creatine kinase(CK),MB isoenzyme of creatine kinase (CKMB) in treatment group at every time (except 10 minutes after aorta occluded) were significantly lower than those in control group( P <0 01 or P <0 05).At every time in both groups,the activity of serum superoxide dismutase(SOD) reduced and the content of malondialdehyde (MDA) increased,especially at the time after reperfusion 10 minutes.Both had obviously difference with those before operation (all P <0 05).Content of MDA in treatment group was significantly lower than that in control group at the time after reperfusion 10 minutes and 30 minutes ( P <0 01 or P <0 05).Activity of NO at the time after reperfusion 180 minutes in treatment group was significantly higher than that in control group ( P <0 05).Conclusions:Astragalus membranaceus injection can reduce the content of MDA and myocardial enzyme's release,improve the activity of NO,NOS and SOD after reperfusion,it protect MIRI effectively.

关 键 词：损伤 缺血-再灌注 黄芪注射液 心肌酶 

分 类 号：R285[医药卫生—中药学]