胸腔镜心脏手术中应用参麦注射液防治体外循环心肌缺血再灌注损伤的临床研究  

Efficacy of Shenmai injection on the myocardial ischemiareperfusion injury in patients underwent thoracoscopic cardiac surgery

作　　者：罗志方[1] 江美兰 李章红[1] 曹西迎 Zhi-fang Luo;Mei-lan Jiang;Zhang-hong Li;Xi-ying Cao(Department of Thoracic Surgery, the First Affiliated Hospital of Gannan Medical College, Ganzhou,Jiangxi 341000, China;Gannan Health Vocational College (Ganzhou Health School),Ganzhou, Jiangxi 341000, China)

机构地区：[1]赣南医学院第一附属医院胸心外科,江西赣州341000 [2]赣南卫生健康职业学院(赣州卫校),江西赣州341000

出　　处：《中国内镜杂志》2018年第3期22-26,共5页China Journal of Endoscopy

基　　金：2014年江西省赣州市科技局科技研究课题项目(No:GZ2014ZSF063)

摘　　要：目的研究参麦注射液在体外循环(CPB)胸腔镜心脏手术中对心肌缺血再灌注损伤的保护作用。方法将在CPB下的胸腔镜心脏手术的18例先天性心脏病患儿随机分为两组(每组9例),对照组和试验组。对照组不给药,试验组给予参麦注射液(2 ml/kg心脏冷停搏液中添加入参麦注射液)。分别于麻醉诱导后(T1)、心脏复跳后(T2)时间点测定样本中血清中以下指标的水平:肌钙蛋白T(c Tn T)、肌酸激酶同工酶质量(CK-MB)和肌红蛋白(Mb),并测定心脏左室射血分数(EF)。结果两组血清中c Tn T、CK-MB和Mb的浓度都是在心脏复跳后与麻醉诱导后相比有明显的增加(P<0.05);在心脏复跳后时间点参麦注射液组的c Tn T、CK-MB和Mb明显低于对照组,而EF明显高于对照组(P<0.05)。结论参麦注射液可以在CPB下胸腔镜心脏手术中对心肌缺血-再灌注损伤有保护作用。Objective To study the protective effect of Shenmai injection on myocardial ischemia reperfusioninjury in patients underwent thoracoscopic cardiac surgery during cardiopulmonary bypass(CPB).Methods18patients with congenital heart disease with CPB thoracoscopic cardiac surgery were randomly divided into two groups(9cases in each group):controlled group and experimental group.The controlled group did not give any interveneddrugs,and the experimental group gave the injection of Shenmai that were added into heart cold cardioplegia(2ml/kg).The levels of the following indexes in the serum were respectively measured just after the time of induction ofanesthesia(T1)and heart resuscitation(T2):Troponin T(cTnT),Creatine kinase isoenzyme(CK-MB)quality,myoglobin(Mb).And at the same time,the left ventricular ejection fraction(EF)was measured.Results Theconcentrations of cTnT,CK-MB and mb in the serum of both groups just after the time of heart resuscitation(T2)were significantly increased more than just after the time of induction of anesthesia(T1)(P<0.05).Butthe concentrations of cTnT,CK-MB and Mb in the experimental group were significantly lower than that in thecontrolled group just after the time of cardiac resuscitation.And EF was significantly higher than the controlled group(P<0.05).Conclusion Shenmai injection can protect the myocardium from ischemia-reperfusion injury in patientsunderwent thoracoscopic cardiac surgery during cardiopulmonary bypass(CPB).

关 键 词：参麦注射液 胸腔镜心脏手术 心肌缺血再灌注损伤 保护作用 

分 类 号：R654.2[医药卫生—外科学]