丙氨酰谷氨酰胺在体外循环下冠脉搭桥手术中对肺保护的研究  

Research on lung protection of alanyl gutamine in coronary bypass operation under extracorporeal circulation

作　　者：尹波[1] 李大宏[1] 张磊[1] 刘大海[1] 

机构地区：[1]山东省莱芜市人民医院胸心外科,山东莱芜271100

出　　处：《实用药物与临床》2013年第7期579-581,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的研究丙氨酰谷氨酰胺在体外循环下行冠脉搭桥手术中对肺功能的保护作用。方法选取体外循环下行冠脉搭桥手术患者40例,随机分为2组,每组20例。观察组于预充液中加入0.5 mg/kg丙氨酰谷氨酰胺注射液,对照组以等量生理盐水替代。结果手术开始后,两组患者白介素-6(IL-6)、肿瘤坏死因子(TNF)及热休克蛋白70(HSP70)均明显升高,于术后24 h开始缓慢下降,术后48 h恢复正常,观察组患者IL-6及TNF-α均明显低于对照组(P<0.05);观察组患者HSP70明显高于对照组(P<0.05);两组患者Cdyn及OI均于手术开始后下降,手术结束时达最低,观察组患者下降小于对照组(P<0.05)。两组患者术后气管插管时间以及ICU监护时间比较差异有统计学意义(P<0.05)。结论体外循环下行冠脉搭桥手术的患者应用丙氨酰谷氨酰胺可有效保护患者肺功能。Objective To study the protective effect on pulmonary function of alanyl glutamine in coronary bypass operation under extracorporeal circulation.Methods 40 patients receiving coronary bypass operation under extracorporeal circulation were selected and divided into 2 groups randomly,20 cases in each group.Observation group was given the pre filled joined with 0.5 mg/kg alanyl glutamine injection,and control group was given the pre filled with equal saline.Results Since the operation began,the IL-6,TNF and heat shock protein 70 of the two groups rose evidently,dropped slowly 24 h after operation,and returned to normal 48 h after operation.IL-6 and TNF-α of observation group were significantly lower than those of control group（P0.05）,but heat shock protein 70 of observation group was significant higher than that of control group（P0.05）.Cdyn and OI of the two groups all dropped after operation,which reached the lowest when the operation was end,and the dropping of the observation group was less than that of the control group（P0.05）.There was significant difference of intubation time after operation and ICU monitoring time of the two groups（P0.05）.Conclusion Applying alanyl glutamine on the patients with coronary bypass operation under extracorporeal circulation can protect the pulmonary function effectively.

关 键 词：丙氨酰谷氨酰胺 热休克蛋白 体外循环 肺保护 

分 类 号：R654.2[医药卫生—外科学]