左旋甲状腺素对体外循环手术过程中心肌及脑组织缺血再灌注损伤的保护作用  

The protective effect of levothyroxine on myocardial and cerebral ischemia reperfusion injury during surgery under cardiopulmonary bypass

作　　者：谢柯祺[1] 陈平[1] 何伟[1] 刘铮 XIE Ke-qi;CHEN Ping;HE Wei;LIU Zheng(Departments of Anesthesiology,Mianyang Central Hospital,Mianyang,Sichuan,China;Departments of cardiothoracic surgery,Mianyang Central Hospital,Mianyang,Sichuan,China)

机构地区：[1]四川省绵阳市中心医院麻醉科,四川绵阳621000 [2]四川省绵阳市中心医院心胸外科,四川绵阳621000

出　　处：《海南医学院学报》2018年第11期1077-1080,共4页Journal of Hainan Medical University

基　　金：四川省绵阳市卫生计生委课题(201430)~~

摘　　要：目的:研究左旋甲状腺素对体外循环手术过程中心肌及脑组织缺血再灌注损伤的保护作用。方法:选择绵阳市中心医院2015年3月~2017年12月期间进行的体外循环下瓣膜置换术患者进行前瞻性研究,随机分入术前接受左旋甲状腺素治疗的优甲乐组及术前进行常规干预的对照组。手术前及手术后12小时,测定心肌及脑组织损伤指标、促炎及黏附分子、抗氧化指标。结果:手术后12小时,两组患者血清中cTnI、LDH、CK-MB、H-FABP、NSE、S100B、CD11b/CD18、sP-selectin、IL-1、IL-10的含量及SjvO2的水平均高于手术前,Cu-Zn SOD、CAT、GSH-Px的含量均低于手术前且优甲乐组患者血清中cTnI、LDH、CK-MB、H-FABP、NSE、S100B、CD11b/CD18、sP-selectin、IL-1、IL-10的含量及SjvO2的水平均低于对照组,Cu-Zn SOD、CAT、GSH-Px的含量均高于对照组。结论:左旋甲状腺素对体外循环手术过程中炎症及氧化应激所致心肌及脑组织的缺血再灌注损伤具有保护作用。Objective：To study the protective effect of levothyroxine on myocardial and cerebral ischemia reperfusion injury during surgery under cardiopulmonary bypass.Methods：Patients who underwent valve replacement under cardiopulmonary bypass in Mianyang Central Hospital between March 2015 and December 2017 were selected and randomly divided into the Euthyrox group who received preoperative levothyroxine therapy and the control group who received routine preoperative intervention.The myocardial and cerebral injury indexes,pro-inflammatory and adhesion molecules as well as antioxidant indexes were measured before operation and 12 hours after operation.Results：12 hours after operation,serum cTnI,LDH,CK-MB,HFABP,NSE,S100 B,CD11 b/CD18,sP-selectin,IL-1 and IL-10 contents as well as SjvO2 levels of both groups were higher than those before operation whereas Cu-Zn SOD,CAT and GSH-Px contents were lower than those before operation（P〈0.05）,and serum cTnI,LDH,CK-MB,H-FABP,NSE,S100 B,CD11 b/CD18,sP-selectin,IL-1 and IL-10 contents as well as SjvO2 level of Euthyrox group were lower than those of control group whereas Cu-Zn SOD,CAT and GSH-Px contents were higher than those of control group（P〈0.05）.Conclusion：Levothyroxine has protective effect on the myocardial and cerebral ischemia reperfusion injury induced by inflammation and oxidative stress during surgery under cardiopulmonary bypass.

关 键 词：体外循环 左旋甲状腺素 缺血再灌注 炎症 氧化应激 

分 类 号：R542.2[医药卫生—心血管疾病]