黄芪注射液抗心肌缺血再灌注损伤的临床研究

目的：探讨黄芪注射液防治体外循环心内直视手术中心肌缺血－再灌注损伤（ＭＩＲＩ）的作用机制。方法：将１２例风湿性心肌病瓣膜置换术和先天性心脑病室内隔缺损修补术患者随机分为对照组和治疗组，每组６例。治疗组通过锁骨下静脉注黄芪注射液４０ｇ；对照组不加中药。检测２组在不同时间的心肌酶、氧自由基含量，一氧化氮（ＮＯ）和一氧化氮合酶（ＮＯＳ）活性。结果：主动脉阻断致心肌缺血及心脏恢复灌注后心肌酶均呈上升趋势，

Clinical study of astragalus membranaceus injection on protecting myocardial ischemiareperfusion injury

Objective:To investigate the mechanism of astragalus membranaceus injection on protecting myocardial ischemiareperfusion injury (MIRI) in open heart surgery under cardiopulmonary bypass.Methods:12 patients with either valvular heart disease or congenital ventricular septal defect were divided randomly into control group and treatment group,six cases in each group.Both groups were undergoing open heart surgery under cardiopulmonary bypass.The treatment group was injected 40 g astragalus membranaceus injection via subclavian,while the control group was not injected traditional Chinese medicine.Myocardial enzyme and oxygen free radical,the activity of nitric oxide(NO),nitric oxide synthase(NOS) in blood sample from via subclavian were measured in both groups at different time after injection.Results:The content of myocardial enzyme in the two groups both presented a tendency to ascend after aorta occluded and released.The content of creatine kinase(CK),MB isoenzyme of creatine kinase (CKMB) in treatment group at every time (except 10 minutes after aorta occluded) were significantly lower than those in control group( P <0 01 or P <0 05).At every time in both groups,the activity of serum superoxide dismutase(SOD) reduced and the content of malondialdehyde (MDA) increased,especially at the time after reperfusion 10 minutes.Both had obviously difference with those before operation (all P <0 05).Content of MDA in treatment group was significantly lower than that in control group at the time after reperfusion 10 minutes and 30 minutes ( P <0 01 or P <0 05).Activity of NO at the time after reperfusion 180 minutes in treatment group was significantly higher than that in control group ( P <0 05).Conclusions:Astragalus membranaceus injection can reduce the content of MDA and myocardial enzyme's release,improve the activity of NO,NOS and SOD after reperfusion,it protect MIRI effectively.