果糖二磷酸钠对缺血心肌围手术期保护作用观察  

Effect of sodium fructose diphosphate on ischemic myocardial protection at perioperative period

作　　者：郭梦[1] 胥雪莲[2] 周晓莉[1] 

机构地区：[1]重庆医科大学附属第一医院心血管内科,重庆400016 [2]重庆医科大学大学城医院心血管内科,重庆401331

出　　处：《西部医学》2017年第3期343-346,350,共5页Medical Journal of West China

基　　金：重庆市卫生计生委医学科研基金(2015MSXM018)

摘　　要：目的观察并探讨果糖二磷酸钠对合并心肌缺血的外科非心脏手术患者围术期的心肌保护作用。方法将86例拟行外科非心脏手术治疗且合并心肌缺血的患者随机分为果糖二磷酸钠预处理组(术前7d持续静滴,20g/d)和常规对照组两组。两组分别于处理前、麻醉前、插管前及拔管后测量平均动脉压、心排出量、缺血修饰白蛋白(ischemia modified albumin,IMA)、人心肌脂肪酸结合蛋白(heart-type fatty acid binding protein,H-FABP)、心肌肌钙蛋白T(cardiac troponin-T,cTnT)含量,并比较两组手术时间和术中心律失常发生情况。结果果糖二磷酸钠预处理组的平均动脉压和心排出量在麻醉前、插管前和拔管后均明显高于同期的常规对照组,IMA、H-FABP和cTnT含量亦明显低于同期常规对照组;另外,对照组术中缺血修饰蛋白含量明显高于术前,而果糖磷酸二钠预处理组术中缺血修饰白蛋白含量却明显低于术前(均P<0.05);同时果糖磷酸二钠预处理组术中心律失常发生率也低于同期常规对照组(P<0.05)。结论果糖二磷酸钠对围术期心肌缺血患者的心肌具有良好的保护作用。Objective To observe and explore the effect of sodium fructose diphosphate on myocardial protection in surgical patients with myocardial ischemia at perioperative period. Method＇s 86 patients ready to surgery with myocardial ischemia were divided into trail group and control group. Trail group was treated with sodium fructose diphosphate （20g/ d） for 7 days before surgery. Mean arterial pressure, cardiac output, the serum concentration of ischemia modified albumin, heart-type fatty acid-binding protein and cardiac troponin-T were all measured at four different time points in two groups, including before treatment, before anesthesia, before and after tube drawing. The total operation time and arrhythmia onset were recorded in two groups. Results The mean arterial pressure and cardiac output were obviously higher in the sodium fructose diphosphate treatment group than the control group before anesthesia, before and after tube drawing, yet the serum concentration of ischemia modified albumin, heart-type fatty acid-binding protein and cardiac troponin-T significantly lower. Besides, the serum concentration of ischemia modified albumin in the trail group was sharply lower in operation than before treatment, while in the control group apparently higher. Meanwhile, the incidence of arrhythmia in operation was less in sodium fructose diphosphate treatment group than the control group. Conclusion Sodium fructose diphosphate has significant protective effect on ischemic myocardium at perioperative period.

关 键 词：果糖二磷酸钠 围手术期 心肌缺血 心肌保护 

分 类 号：R605[医药卫生—外科学] R542.2[医药卫生—临床医学]