丹参停搏液在婴幼儿心内直视手术中的心肌保护作用

目的:探讨含丹参注射液的停搏液在婴幼儿心内直视手术中的心肌保护作用。方法:30例先天性室间隔缺损的婴幼儿随机分成丹参组(15例)和对照组(15例),两组均在体外循环下行室间隔缺损修补术。丹参组在4:1含血停搏液中加入丹参注射液(20mL/500mL),对照组单用4:1含血停搏液。所有患儿均于体外循环前(T1)、主动脉开放即刻(T2)、主动脉开放后30min(T3)、主动脉开放后3h(T4)、主动脉开放后24h(T5)测定心肌肌钙蛋白-I(cTnI)、肌酸激酶同工酶(CK-MB)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平,并观察两组体外循环前后心肌超微结构。记录心脏复跳情况、机械通气时间和ICU监护时间。结果:在体外循环后丹参组CK-MB、cTnI、MDA血浆浓度低于对照组,SOD血浆浓度高于对照组。术后心肌组织超微结构显示心肌细胞损害程度丹参组较对照组轻。丹参组心脏自动复跳率高于对照组(P<0.05),机械通气时间及ICU监护时间差异无统计学意义。结论:丹参停搏液能减轻婴幼儿体外循环手术中的心肌损害,对心肌缺血再灌注损伤有保护作用。

Myocardial protection of cardioplegic solution enriched with salvia miltiorrhiza injection in cardiopulmonary bypass in infants

Objective To explore the myocardial protective effect of cardioplegic solution enriched with salvia miltiorrhiza(SM) injection in cardiopulmonary bypass(CPB) in infants. Methods Thirty patients undergoing remedy operation for atrial septal defect (VSD) under cardiopulmonary bypass were preoperatively randomly divided into SM group (n = 15) and control group (n = 15). SM group received SM injection in cardio-plegic solution,control group did not receive SM. Blood samples were taken for the measurement of CK-MB,cTnI,SOD,MDA before CPB;1/2 h、3 h and 24 h after aortic declamping and ultrastructure examination under an electron microscope were studied. The rate of automatic resume pulsating,the duration of mechanical ventilation and ICU settlings were analyzed and calculated. Results After CPB,the levels of CK-MB,cTnI,MDA in SM group were lower than those in control group,the levels of SOD in SM group were higher than those in control group. Ultrastructural alterations indicated that injury of myocytes in SM group was less severe than that in control group. The spontaneous return rate in SM group increased compared with control group(P < 0.05). There were no significant differences of the duration of mechanical ventilation and ICU settling between two groups. Conclusion Cardioplegic solution enriched with SM injection can protect the heart from ischemia-reperfusion injury during and after CPB in infants.