磷酸肌酸钠停搏液在瓣膜置换术中的心肌保护作用  

Clinical observation of phosphocreatine sodium on myocardial protection in patients undergoing cardial valve replacement

作　　者：张莉莉[1] 叶晓青[1] 

机构地区：[1]广东省深圳市孙逸仙心血管医院麻醉科,广东深圳518020

出　　处：《中国现代医学杂志》2014年第20期98-100,共3页China Journal of Modern Medicine

摘　　要：目的观察磷酸肌酸钠对瓣膜置换患者心肌缺血再灌注损伤的保护作用。方法 40例行瓣膜置换患者随机分成两组,实验组在心脏停搏液中加入10 mmol/L的磷酸肌酸钠,对照组未用药。观察并记录两组患者体外循环时间、主动脉阻断时间、体外循环辅助时间、心脏自动复跳情况。分别于主动脉阻断前、开放后2 h和24 h采集患者颈内静脉血,检测肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心肌钙蛋白I(cTnI)。结果两组主动脉阻断时间、体外循环时间差异无统计学意义,而开放后辅助循环时间实验组为(38.2±14.3)min,明显低于对照组(47.1±13.9)min(P<0.05)。两组患者在主动脉开放后2 h和24 h,血清CK、CK-MB、cTnI含量均升高,实验组升高幅度明显低于对照组(P<0.05)。结论磷酸肌酸钠加入停搏液中可减轻瓣膜置换患者术中心肌缺血再灌注损伤。[Objective] To investigate the myocardial protection of phosphocreatine sodium on myocardial ischemia-repeffusion injury in patients undergoing cardial valve replacement. [Methods] Forty patients under- going cardial valve replacement were randomly assigned into two groups： treatment group （n =20） and control group （n =20）. In treating group, 10 mmol/l phosphoereatine sodium were added into the cardioplegia liquid. In control group no durgs was given into the cardioplegia liquid. The cardiopulmonary bypass （CPB） time, aortic cross-clamp （ACC） time, CPB assisting time, and automatically restoring of heart beat were observed and recorded, The blood sample were obtained from internal jugular vein before operation, 2 hours and 24 hours after operation to examine the concentration of CK, CK-MB, eTnl. [Results] The time of CPB assisting in treating group was shorter than in control group （P〈0.05）. The concentration of CK, CK-MB, cTnl increased significantly at 2 hours and 24 hours after operation in both groups. As compared to control group, the concentration of CK, CK-MB, eTnl in treating group decreased significantly at 2 hours and 24 hours after operation （P〈0.05）. [Conclusion] Phosphocreatine sodium can relieve the myocardial ischemia-repeffusion injury to some degree in patients undergoing cardial valve replacement.

关 键 词：再灌注损伤 磷酸肌酸钠 瓣膜置换术 心肌保护 

分 类 号：R654.1[医药卫生—外科学]