丹参川芎嗪对小儿缺血再灌注心肌保护作用的临床研究  

Clinical Study on the Protective Effect of Salvia Miltiorrhiza Ligustrazine on Myocardial Ischemia Reperfusion in Children

作　　者：袁超 高宁阳 李永乐 杨亮 李明洁 黎昆伟 YUAN Chao;GAO Ningyang;LI Yongle;YANG Liang;LI Mingjie;LI Kunwei(Guangdong Women and Children Hospital,Guangdong Guangzhou 510000,China)

机构地区：[1]广东省幼保健院,广东广州510000

出　　处：《中医药临床杂志》2021年第12期2393-2396,共4页Clinical Journal of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(20211052)。

摘　　要：目的:探讨丹参川芎嗪对小儿缺血再灌注心肌保护作用。方法:收集ASAⅡ或Ⅲ级,行室间隔缺损修补术小儿80例,年龄3~8岁,采用双盲、随机平均分为对照组(C组)、试验组(D组),每组40例。2组小儿均采用相同的麻醉诱导方式,经鼻气管插管。D组小儿在体外循环预充液中加入0.3ml/kg丹参川芎嗪注射液,0.9%生理盐水稀释至10ml;C组小儿加入等量10 ml 0.9%生理盐水。检测2组小儿在胸骨劈开前(T_(0))、主动脉开放即刻(T_(1))、主动脉开放后6h(T_(2))、12h(T_(3))、24h(T_(4))、48h(T_(5))的血清肌酸激酶(CK)、血清肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTnI)、丙二醛(MDA)、超氧化物歧化酶(SOD);观察T_(1)时刻心脏自动复跳率、心律失常发生率。结果:与C组比较,D组小儿在T_(0)时刻,CK、CK-MB、cTnI、MDA无明显差异,在T_(1)、T_(2)、T_(3)、T_(4)、T_(5)时刻,CK、CK-MB、cTnI、MDA明显降低、SOD明显升高,差异具有统计学意义;2组小儿CK、CK-MB、cTnI、MDA随时间先升高后降低,SOD先降低后升高。与C组比较,D组小儿T_(1)时刻心脏自动复跳率无统计学差异,D组小儿心律失常发生率(5.0%vs 27.5%)明显降低,差异具有统计学意义(c^(2)=7.44,P=0.006)。结论:丹参川芎嗪在体外循环时加入预充液中,对小儿缺血再灌注心肌具有保护作用。Objective:To explore the protective effect of Danshen and Ligustrazine on children’s ischemia-reperfusion myocardium.Methods:Collect 80 children with ASA gradeⅡorⅢ,who underwent ventricular septal defect repair,aged 3 to 8 years old,were double-blind and randomly divided into control group(group C)and experimental group(group D),each with 40 example.The two groups of children all used the same anesthesia induction method and were intubated through the nose and trachea.Children in group D were added with 0.3ml/kg Danshen ligustrazine injection to the extracorporeal circulation priming solution and diluted with 0.9%saline to 10ml;children in group C were added with the same amount of 10 ml 0.9%saline.Serum creatine kinase(T_(0)),immediately after the aorta opening(T_(1)),6h(T_(2)),12h(T_(3)),24h(T_(4)),and 48h(T_(5))after the opening of the aorta were detected in the two groups of children.CK),serum creatine kinase isoenzyme(CK-MB),troponin(cTnI),malondialdehyde(MDA),superoxide dismutase(SOD);observe the heart’s automatic recovery rate at T_(1),The incidence of arrhythmia.Results:Compared with group C,children in group D had no significant differences in CK,CK-MB,cTnI,and MDA at time T0.At T_(1),T_(2),T_(3),T_(4),and T_(5),CK,CK-MB,cTnI,MDA decreased significantly,SOD increased significantly,the difference was statistically significant;CK,CK-MB,cTnI,MDA of the two groups of children increased first and then decreased over time,and SOD first decreased and then increased.Compared with group C,there was no statistically significant difference in the rate of automatic return of the heart in children in group D at T_(1),and the incidence of arrhythmia in group D(5.0%vs 27.5%)was significantly lower,and the difference was statistically significant(χ^(2)=7.44,P=0.006)).Conclusion:Danshen ligustrazine added to the priming solution during cardiopulmonary bypass has a protective effect on children’s ischemia-reperfusion myocardium.

关 键 词：丹参川芎嗪 小儿 缺血再灌注心肌 

分 类 号：R272[医药卫生—中医儿科学]