法舒地尔对体外循环下二尖瓣置换术患者心肌缺血/再灌注损伤的心肌保护作用  

Protective effect of fasudil hydrochloride against myocardial ischemia/reperfusion injury in patients subject to mitral valve replacement

作　　者：李倩[1] 陈立华[1] 刘苏[1] 尚艳慧 尹晨[1] 刘林力[1] 

机构地区：[1]河北医科大学第二医院心脏外科,石家庄050000

出　　处：《中华实验外科杂志》2015年第9期2273-2275,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 观察法舒地尔对二尖瓣置换术患者心肌缺血/再灌注损伤的保护作用.方法 将二尖瓣置换术患者40例随机分为实验组（20例,法舒地尔1 mg/kg）和对照组（20例,等量生理盐水）.在麻醉后（T1）及体外循环后不同时间（T2 ～T5）测定血浆乳酸脱氢酶（LDH）、肌酸激酶同工酶（CK-MB）、肌钙蛋白I（cTnI）浓度,并取心肌标本检测细胞凋亡率.结果 体外循环结束后,实验组LDH （U/L）比对照组低,差异有统计学意义（T4：486.05 ±39.52比528.13±47.65,T5：551.80±35.43比593.88±48.89,P＜0.01）.实验组CK-MB （U/L）比对照组低,差异有统计学意义（T3：78.39±8.27比88.68±16.18,P＜0.05,T4：62.46±6.10比72.37±11.85,P＜0.01,T5：47.81±8.19比54.56±9.21,P＜0.05）.实验组cTnI（μg/L）比对照组低,差异有统计学意义（T3：4.40±1.12比5.80±1.51,T4：4.93±1.23比6.49±1.62,T5：3.99±1.20比5.80±1.30,P＜0.01）.实验组心肌细胞凋亡率明显低于对照组[（7.48±2.18）％比（12.73±2.74）％,P＜0.01].结论 对体外循环下二尖瓣置换术患者,法舒地尔可降低术后LDH、CK-MB、cTnI水平,抑制细胞凋亡,减轻心肌缺血/再灌注损伤,具有心肌保护作用.Objective To observe the protective effect of fasudil hydrochloride against myocardial ischemia/reperfusion injury in patients undergoing mitral valve replacement （MVR）.Methods Forty patients who received MVR surgery were randomly divided into two groups：treatment group （T group,20 cases,fasudil hydrochloride,1 mg/kg） and control group （C group,20 cases,normal saline）.The concentrations of lactate dehydrogenase （LDH）,Creatine kinase isoenzyme MB （CK-MB）,and Cardiac troponin I （cTnI） in plasma were recorded and analyzed after induction of anesthesia （T1） and at 5 time points after cardiopulmonary bypass （CPB,T2-T5）.Myocardial samples were selected to detect cell apoptosis rate.Results After CPB,LDH （U/L） in T group was significantly lower than in C group at T4 and T5 （486.05±39.52 vs.528.13±47.65;551.80±35.43 vs.593.88 ±48.89;P＜0.01）.CK-MB （U/L） in T group was significantly lower than in C group at T3,T4,and T5 （78.39 ±8.27 vs.88.68 ± 16.18,P＜0.05;62.46 ±6.10 vs.72.37 ±11.85,P＜0.01;47.81 ±8.19 vs.54.56±9.21,P＜ 0.05）.cTnI （μg/L） in T group was significantly lower than in C group at T3,T4,and T5 （4.40 ± 1.12 vs.5.80 ± 1.51,4.93 ± 1.23 vs.6.49 ± 1.62,3.99 ± 1.20 vs.5.80 ± 1.30,P ＜ 0.01）.The apoptosois rate of cardiomyocytes in T group was significantly lower than in C group [（7.48 ± 2.18） ％ vs.（12.73 ± 2.74） ％,P ＜ 0.01].Conclusion For patients undergoing MVR surgery with CPB,fasudil hydrochloride can decrease the levels of LDH,CK-MB and cTnI in plasma,inhibit apoptosis of cardiomyocytes and relieve myocardial ischemia/reperfusion injury,exerting the protective effects on myocardia.

关 键 词：盐酸法舒地尔 体外循环 缺血/再灌注损伤 心肌保护 

分 类 号：R541[医药卫生—心血管疾病]