依达拉奉和甘露醇对心肌缺血再灌注损伤保护作用的临床研究

目的 观察依达拉奉和甘露醇对体外循环（CPB）心脏手术后心肌缺血再灌注损伤的保护作用.方法 将CPB心脏手术后的80例患者随机分为依达拉奉组、甘露醇组、依达拉奉联合甘露醇组（联合组）和对照组,每组各20例,同时分别于术前及主动脉开放后2、4、12和24 h时测定血超氧化物歧化酶（SOD）活性及丙二醛（MDA）、肌酸磷酸激酶同工酶（CK-MB）、肌钙蛋白I（cTnI）含量.结果 CPB术后各组血CK-MB、cTnI、MDA水平均较术前明显升高,依达拉奉组、甘露醇组及联合组术后各时间点的血CK-MB、cTnI、MDA水平均较对照组降低（均P＜0.05或0.01）;各组患者血SOD水平在开放主动脉后均较术前下降,依达拉奉组、甘露醇组及联合组在术后各时点的血SOD下降水平均低于对照组（均P＜0.05）.结论 依达拉奉和甘露醇均可以提高心肌细胞血SOD活性,减少血MDA的产生,从而减轻心肌缺血再灌注损伤,有效的保护心肌功能.

Protective effect of edaravone combined with mannitol on myocardial reperfusion injury

Objective To observe the protective effect of edaravone combined with mannitol on myocardial ischemic and reperfusion injury during cardiopulmonary bypass（CPB）. Methods Eighty patients undergoing valve replacement were randomly divided into four groups,with edaravone group receiving edaravone, mannitol group receiving mannitol, combined group receiving both of edaravone and minnitol and control group without edaravone or minnitol. The blood samples were taken at five different intervals.before surgery, 2 hours, 4 hours, 12 hours and 24 hours after CPB,to determine the levels of superoxide disrnutase （SOD）, malondialdehyde （MDA）, CK-MB and cTnl. Results CPB plasma concentration of CK-MB and cTnl increased in all groups, and it was much higher in control group （P〈0.05）. SOD fell continuously after declamping aorta. The changes of SOD in control group was significantly lower than that in the other three groups （P〈0.05）. The level of MDA increased in all groups with more marked elevation in control group （P〈0.05）. Conclusion This study suggests that edaravone and mannitol can improve the activity of SOD and decrease the production of MDA, thereby attenuating myocardial ischemic and reperfusion injury.