川芎嗪对心内直视手术心肌保护的临床研究

目的探讨川芎嗪对瓣膜置换患者行体外循环心内直视手术心肌保护的效果。方法临床随机选取拟行单瓣膜置换的风湿性心脏瓣膜病患者40例，心功能Ⅱ～Ⅲ级，随机分为治疗组和对照组（每组20例）。除治疗组在体外循环预充液中加入盐酸川芎嗪注射液3mg／kg外，其他术中处理两组均相同。分别检测两组术前，主动脉开放时，术后24、48h时患者血液中肌钙蛋白I（cTnI）、肌酸激酶（CK）、肌酸激酶同功酶（CK—MB）、丙二醛（MDA）含量，并记录体外循环辅助时间、术后正性肌力药物用量。结果①cTnI、CK、CK—MB、MDA含量的变化：两组患者术前含量差异无统计学意义，在主动脉开放后各时间点两组间差异有统计学意义（P〈0．05）。②其他：治疗组体外循环辅助时间较对照组短，术后正性肌力药物用量较对照组少，两组比较差异有统计学意义（P〈0．05）。结论川芎嗪对体外循环心内直视手术造成的心肌细胞损伤具有良好的保护作用。

Clinical study of tetramethylpyrazine in myocardial protection of patients performed Open heart surgery

Objective To study the myocardial protective effects of tetramethylpyrazine （TMP） on patients undergoing open heart surgery with extracorporeal circulation. Methods Forty patients with rheumatic heart valvular disease whose heart function were in NYHA class Ⅱ- Ⅲ were respectively selected and randomly divided into two groups （n=20 each）：control group and TMP group. There were no differences between two groups except that TMP group received the ligustrazine hydrochloride injection （3 mg/kg） in priming solution of extracorporeal circulation. The changes of lactate cardiac troponin I（cTnI）, creatine kinase （CK）, isoenzymes of creatine kinase （CK-MB） and malonaldehyde （MDA） levels in the serum were measured pre-operation, aortic declamping and 24,48 hours after operation. The time of assistting extracorporeal circulation and the dosage of inotropic agent after operation were measured. Results （1）Changes in the serum levels of cTnI, CK, CK-MB and MDA： There were no significant differences between two groups at the point of T1 （P〉0.05）,but there were significant differences between two groups at the points of T2 to T4（P〈0.05 ）. （2）The time of assistting extracorporeal circulation in the TMP group was less than those in the control group. The dosage of inotropic agent after operation in the TMP group were lower than those in the control group（P〈0.05 ）. Conclusion TMP shows myocardial protective function in patients undergoing open heart surgery with cardiopulmonary bypass.