黄芪对儿童缺血再灌注心肌保护作用的临床研究  

Clinical Study on the Myocardial Protection of Astragalus on Ischemia-Reperfusion in Children

作　　者：黎昆伟[1] 宋匀韵[1] 吴永红[1] 蔡明阳[1] 孙维国[1] 邓恋[1] 孙善权[1] 胡祖荣[1] LI Kunwei;SONG Yunyun;WU Yonghong(Guangdong Women and Children Hospital,Guangzhou 511400,China)

机构地区：[1]广东省妇幼保健院,广东广州511400

出　　处：《中国医学创新》2018年第12期66-69,共4页Medical Innovation of China

基　　金：广东省中医药局科研课题(20152020)

摘　　要：目的:探究黄芪对儿童缺血再灌注心肌的保护作用。方法:选取2015年11月-2017年3月本院拟择期行室间隔缺损修补术或房间隔缺损修补术的儿童60例,按照随机数字表法分为试验组和对照组,各30例。两组麻醉方法、灌注方法及体外循环方法相同,对照组给予常规治疗,试验组在对照组基础上给予黄芪注射液治疗。比较两组不同时间的血浆肌钙蛋白(c Tn I)和肌酸磷酸激酶同工酶(CK-MB),心肌超微结构变化及心脏电生理指标。结果:电镜观察显示试验组心肌细胞超微结构损伤比对照组小;主动脉开放后3、6、12、24、48 h,试验组血清CK-MB水平均明显低于对照组(P<0.05);开放即刻及开放后3、6、12、24、48 h,试验组c Tn I水平均低于对照组(P<0.05);主动脉开放后,两组均自动复跳,心脏自动复跳率比较差异无统计学意义(P>0.05);试验组心律失常发生率为3.33%,明显低于对照组的20.00%(X^2=4.043,P=0.044)。结论:黄芪对儿童缺血再灌注心肌保护作用显著。Objective：To investigate the protective effect of Astragalus on myocardial ischemia-reperfusion in children.Method：A total of 60 children who underwent repair of ventricular septal defect or atrial septal defect repair in our hospital from November 2015 to March 2017 were selected.According to the random number table method,they were divided into experimental group and control group,30 cases in each group.The anesthetic methods,perfusion methods and cardiopulmonary bypass in two groups were the same,the control group was given routine treatment,and experimental group was treated with Astragalus injection on the basis of control group.Plasma troponin（c Tn I） and creatine phosphokinase isoenzyme（CK-MB） at different times,myocardial ultrastructural changes and cardiac electrophysiological indexes in two groups were compared.Result：Electron microscopy showed that the ultrastructural damage of myocardial cells in experimental group was smaller than that of control group.After aortic opening 3,6,12,24 and 48 h,the levels of CK-MB in experimental group were significantly lower than those of control group（P〈0.05）.Open immediate and after opening 3,6,12,24 and 48 h,the levels of c Tn I in experimental group were lower than those of control group（P〈0.05）.After aortic opening,they were automatically recovered,the rate of automatic heart beating was compared,the difference was not statistically significant（P〉0.05）,the incidence of arrhythmia in experimental group was 3.33%,which was significantly lower than 20.00% in control group（ χ^2=4.043,P=0.044）.Conclusion：Astragalus has a significant protective effect on myocardial ischemia-reperfusion in children.

关 键 词：黄芪 心肌缺血再灌注 保护 儿童 

分 类 号：R272[医药卫生—中医儿科学]