美心力对心脏直视术中心肌缺血/再灌注损伤的保护作用

目的研究美心力在体外循环(extracorporeal circulation,ECC)心脏直视术中心肌缺血/再灌注损伤的心肌保护作用。方法择期ECC心脏瓣膜手术患者30例,随机分为对照组和美心力组(实验组)。对照组不给药,实验组将美心力40 mg加入心脏停搏液中。观察诱导停搏时间、心脏复跳情况,分别于麻醉诱导后、再灌注2 h、6h、24 h,取患者静脉血测定样本中下列各指标的水平:肌酸激酶同工酶(CKMB)、乳酸脱氢酶(LDH)、心肌肌钙蛋白I(cTnI)。结果诱导停搏时间实验组较对照组显著减少;自动复跳率实验组(14/15)较对照组(9/15)高,再灌注2 h、6 h、24 h两组CKMB、LDH、cTnI均逐渐升高,但实验组显著低于对照组。结论美心力可以减轻ECC心脏直视术中心肌缺血/再灌注损伤。

The Protective Effect of Cyclic Adenosine Monomphsopate on Myocardial Ischemia-Reperfusion Injury During Open Heart Surgery

OBJECTIVE To investigate the protective effect of cyclic adenosine monomphsopate(cAMP)on ischemia-reperfusion injury during open heart surgery under extracorporeal circulation(ECC).METHODS 30 patients undergoing elective cardiac operation for valve replacement were prospectively randomized into two groups: group M(n=15) receiving cAMP and group C(n=15) not receiving it.The incidence rate of heart spontaneous rebeating,defibrilation,arrhythmia were recorded.Blood samples were withdrawed from central vein for the measurements of CKMB,LDH,cTnI after induction,reperfusion 2 h,6 h and 24 h.RESULTS The ratio of myocardial auto-resuscitation in group M(93.3%)was significantly higher than that in group C(60.0%).The values of CKMB,LDH and cTnI in M group after ECC were significantly lower than those in group C at different time points(P<0.05).CONCLUSION cAMP may significantly protect the myocardial from ischemia-reperfusion injury.