外源性磷酸肌酸联合二丁酰环磷腺苷在不停跳冠脉搭桥术中心肌保护作用的研究  

On Myocardium Protective Effect of Exogenous Creatine Phosphate Dibutyryl Cyclic Adenosine Phosphate Calcium Two on OPCAB

作　　者：王保申[1] 刘苏[2] 

机构地区：[1]保定市第一中心医院,河北保定071028 [2]河北医科大学第二附属医院,河北石家庄050005

出　　处：《北华大学学报（自然科学版）》2014年第4期490-494,共5页Journal of Beihua University（Natural Science）

摘　　要：目的探讨磷酸肌酸钠和二丁酰环磷腺苷钙两药在不停跳冠脉搭桥(OPCAB)术中保护心肌、减轻缺血-再灌注损伤的作用.方法选取60名冠心病三支病变者,随机分为3组(实验组、对照组1和对照组2),比较各组即刻心肌酶CK,CK-MB,cTNI值,每组患者术后使用正性肌力药物例数和使用时间,术后心律失常和低心排综合征的发生率.结果 1)CK值:实验组和对照组1比较,术后24 h有统计学意义(P<0.05),术后6,12,48,72 h无统计学意义(P>0.05);实验组和对照组2比较,术后6,12,24,48,72 h均有统计学意义(P<0.05).2)CK-MB值:实验组和对照组1比较,术后12 h有统计学意义(P<0.05),术后6,24,48,72 h无统计学意义(P>0.05);实验组和对照组2比较,术后6,12,24,48,72 h均有统计学意义(P<0.05).3)cTNI值:实验组和对照组1比较,术后6,12,24,48,72h均无统计学意义(P>0.05);实验组和对照组2比较,术后6,12,24,48,72h均有统计学意义(P<0.05).结论两药联合应用能更好地保护心肌.Objective Myocardium protective effect of exogenous creatine phosphate combined dibutyryl cyclic adenosine phosphate calcium two on OPCAB. Methods We selected 60 case with coronary heart disease three lesions,and randomly divided into 3 groups （ experimental group, control group 1 and control group 2 ） . We measured the CK,CK-MB,cTNI of myocardial enzymes instantly by collecting venous blood. We compared and positive inotropic drug cases and using time of each group,the incidence of arrhythmia and low cardiac output syndrome after operation. Results （1） There was difference on the CK between the experimental group and the control group 1 after 24 h（P〈0. 05）,and no difference after 6,12,48,72 h（P〉0. 05）. There was difference on the CK-MB between the experimental group and the control group 2 after 6,12,24,48,72 h（P〈0. 05）. （2）There was difference on the CK-MB between the experimental group and the control group 1 after 12 h （P〈0. 05）,but where was no difference after 6,12,24,48,72 h（P〉0. 05）. There was difference on the CK-MB between the experimental group and the control group 2 after 6 ,12 ,24 ,48 ,72 h （ P〈0 . 05 ） . （ 3 ） There was no difference on the cTNI between the experimental group and the control group 1 after 6,12,24,48,72 h （P〉0. 05）,but there＆amp;nbsp;was difference on the cTNI between the experimental group and the control group 2 after 6 ,12 ,24 ,48 ,72 h （ P〈0. 05）. Conclusion We must use two kinds of medicines reasonably for better myocardial protective effect.

关 键 词：不停跳冠脉搭桥术(OPCAB) 冠心病 磷酸肌酸钠 二丁酰环磷腺苷钙 心肌保护 心肌酶 心功能 

分 类 号：R725[医药卫生—儿科]