HTK液对危重症心脏瓣膜病患者瓣膜置换术中的心肌保护作用  

Myocardial protection of HTK solution on patients with critical cardiac valve disease during the valve replacement

作　　者：高鲁方[1] 向道康[1] 周涛[1] 张正刚[1] 朱西安[1] 

机构地区：[1]贵州省人民医院心外科,贵州贵阳550002

出　　处：《贵州医药》2015年第10期871-873,共3页Guizhou Medical Journal

基　　金：贵州省优秀科技人才省长基金(200764)

摘　　要：目的研究HTK液对危重症心脏瓣膜病患者心脏停跳手术过程中对心肌保护的效果。方法选取危重症心脏瓣膜病瓣膜置换患者72例,随机分3组(每组24例),术中分组使用心脏停跳液:4∶1血晶冷停搏液(BC组)、St.ThomasⅡ液(CC组)及HTK液(HTK组)。分别于体外循环转流前及主动脉开放后4、12、24、48和72h测血中肌钙蛋白I(cTnI)及肌酸激酶同工酶(CK-MB)含量。观察术后恶性心律失常发生率、多巴胺应用时间、低心排发生率等临床指标。结果 3组患者cTnI、CK-MB在主动脉开放后逐步升高,但HTK组上升的幅度<BC、CC组(P<0.05)。HTK组术后心脏自动复跳率、恶性心律失常发生率、多巴胺应用时间等临床指标均优于BC、CC组(P<0.05)。结论在危重症心脏瓣膜病患者瓣膜置换手术中,HTK液与传统的心脏停搏液比较具有更好的心肌保护作用。Objective To research the effect of HTK solution on myocardial protection of valve replacement on patients with critical valve disease.Method 72 critical valve disease patients were divided into three groups（each group n=24）,which were separately received HTK solution,cold blood cardioplegic solution and St·ThomasⅡcardioplegic solution during the operation.Serum level of cardiac troponin I（cTnI）and creatine kinase（CK）-MB were measured before aortic clamped,and 4h,12 h,24h,48 hand 72hafter aortic declamped.The clinical parameters were calculated and documented.Result The clinical parameters including the auto-beating rate,incidence of malignant arrhythmia after the operation,the time of dopamine drugs application,HTK group was better than BC and CC groups（P〈0.05）.The serum levels of cTnI and CK-MB were significantly lower in group HTK than groups BC and CC（P〈0.05）.Conclusion Comparing to traditional cardioplegic solution,HTK solution has better myocardial protection in the valve replacement of critical valve disease patients.

关 键 词：HTK液 瓣膜置换术 心肌保护 危重症心脏瓣膜病 

分 类 号：R542.5[医药卫生—心血管疾病]