左-卡尼汀对心内直视手术患者心肌酶CK、CK-MB的影响

目的:探讨左-卡尼汀对体外循环(CPB)下行先天性心脏病(CHD)心内矫治术患者CK、CK-MB的影响。方法:选择CPB下行心内直视手术的CHD患者40例,随机分为实验组及对照组,每组各20例。实验组在术中于ST.Thomas号冷晶体停跳液中加入左-卡尼汀(6g/L)行冠状动脉顺行灌注;对照组则使用ST.Thomas号冷晶体停跳液。两组其他处理相同。分别于术前、主动脉阻断10min、主动脉开放后0h、1h、2h、6h及24h采取静脉血,测定血清肌酸激酶(CK)及其同功酶(CK-MB)水平。结果:两组CK、CK-MB水平于主动脉开放后显著升高,但实验组CK水平在主动脉开放后2h及6h显著低于对照组(P<0.05),实验组CK-MB水平于主动脉开放后1h、2h及6h显著低于对照组(P<0.05)。结论:在心内直视手术中,左-卡尼汀作为心脏停跳液的成分,对心肌具有较好的保护作用。

Effect of L-carnitine on myocardial enzymes CK and CK-MB in patients undergoing open cardiac operation under cardio-pulmonary bypass

Objective: To investigate the effect of L-carnitine on myocardial enzymes CK and CK-MB in patients with Congenital Heart Disease(CHD) undergoing open cardiac operation with cardio-pulmonary bypass(CPB).Methods: 40 patients with CHD were randomly divided into two groups,Test group and Control group(n=20 in each group).L-carnitine was put in the cold ST.ThomasⅡcrystal cardiac arresting liquid in the test group(6g/L),Other experimental conditions were the same between two groups.Before operation,20 minutes after the aortic clamping and at 0h、1h、2h、6h、24h after the aortic declamping,venous blood was drawn to test the level of serum creatine kinase (CK) and CK-MB isozyme.Results: The level of CK and CK-MB had no difference between 2 groups before operation.From the end of CPB,the level of CK and CK-MB were significantly lower in the Test group than that in the Control group(P<0.05).Conclusion: L-carnitine as an ingredient of cardioplegia solution has a good protective effect on myocardium in patients with CPB.