米利酮对风湿性心脏病患者围术期心肌酶谱和丙二醛的影响  

Effects of milrinone on serum myocardial enzymes and malondialdehyde in perioperative patients undergoing valve replacement

作　　者：张建欣[1] 徐美英[1] 张富军[1] 沈茜[1] 

机构地区：[1]第二军医大学长海医院麻醉科,上海200433

出　　处：《第二军医大学学报》2000年第6期551-553,共3页Academic Journal of Second Military Medical University

基　　金：军队医药卫生科研基金课题项目(98D040);上海市青年科学基金!资助项目(98ZB14036)

摘　　要：目的 :观察米利酮对风湿性心脏病 (风心病 )患者瓣膜置换术围术期心肌酶谱和膜脂质过氧化产物丙二醛 (MDA)的影响。方法 :2 0例心功能 ～ 级瓣膜置换术患者 ,随机分为 A和 B组 (每组 10例 )。入室后 ,A组 10 m in内予以负荷剂量米利酮 30μg/ kg,继以 0 .5μg / (kg· min)静脉输注 ;B组以相同速度推注生理盐水。分别于麻醉诱导前 (T1 )、诱导后 30 min(T2 )、主动脉阻断后 30 m in(T3)、主动脉开放后 10 m in(T4)、主动脉开放后 30 min(T5 )、体外循环后 30 min (T6 )、体外循环后8h(T7)、术后 2 4h (T8)和术后 72 h(T9)从肺动脉采取混合静脉血 ,用全自动生化仪测定肌酸激酶 (CK)、肌酸激酶 -同功酶(CK- MB) ;用硫代巴比妥酸法测定 MDA。 结果 :两组 T4～ T9的 CK,CK- MB值显著升高 ;A组 T3～ T9的 CK值显著低于同时间点的 B组 (P<0 .0 5 ) ,但两组间各时间点的 CK- MB均无显著差异。B组 T6 ～ T8各时间点的 MDA值明显升高 ,A组仅在T7升高 ;但两组相比均无显著差异。 结论 :米利酮可明显降低血中的 CK水平 ,但对 CK- MB及 MDA无显著影响。Objective: To evaluate the effects of milrinone on serum myocardial enzymes and malondialdehyed (MDA), a lipid peroxidation product, in the perioperative patients undergoing valve replacement. Methods: Twenty patients, scheduled for valve replacement were randomly divided into 2 groups: group A and group B. Before induction of general anesthesia , milrinone was administrated at a 30 μg/kg bolus dose progressively in 10 min, followed by a continuous infusion of 0.5 μg/(kg·min) in group A and the same volume of saline was administrated in group B. The mixed venous blood samples were obtained from pulmonary artery at the following time points: before induction of anesthesia (T 1), 30 min after anesthesia (T 2), 30 min after the cross clamping of aorta (T 3 ), 10 and 30 min after the removal of the aorta clamping (T 4,5 ), 30 min and 8 h after CPB(T 6,7 ), 24 and 72 h after operation (T 8,9 ). Creatine phosphokinase (CK) and creatine phosphokinase isoenzyme (CK MB) were measured with the auto biochemical analytical machine. MDA level in serum was estimated by the method of thiobarbituric acid. Results: The values of CK and CK MB were increased significantly in 2 groups from the point T 4 to T 9 ( P <0.01) . CK in group B were increased markedly from the point T 3 to T 9 compared with group A, but the values of MDA and CK MB had no significant difference at the same point in 2 groups. Conclusion: Milrinone may significantly decrease the level of CK, but there is no marked influence on CK MB and MDA.

关 键 词：米利酮 瓣膜置换术 心肌酶谱 丙二醛 风湿性心脏病 

分 类 号：R654.2[医药卫生—外科学]