丹参注射液对缺血再灌注损伤心肌保护作用

目的研究丹参注射液对风湿性二尖瓣膜置换术病人缺血再灌注损伤心肌的保护作用。方法选取体外循环风湿性二尖瓣膜置换术病人60例,随机分为冶疗组(Ⅰ组,n=30例)、对照组(Ⅱ组,n=30例),两组灌注方法及体外循环方法相同。冶疗组病人于手术开始前、升主动脉开放后静注丹参注射液0.2 mL/kg,对照组给予等容量的平平衡盐溶液。于手术开始前(T0)、心肺转流(CPB)后30 min(T1)、复灌后15 min(T2)、6小时(T3)、12小时(T4)、24小时(T5)共6个时点取颈内静脉血检测磷酸肌酸激酶(CK)、磷酸肌酸激酶同功酶(CK-MB)、乳酸脱氢酶(LDH)、肌钙蛋白(CTnI)的水平及丙二醛(MDA)、超氧化物歧化酶(SOD)的水平;记录两组体外循环时间、主动脉阻断时间,以及体外循环后血管活性药物的用量。观察心脏大血管开放后,心脏自动复跳率,室性心律失常发生率。结果Ⅰ组CK、CK-MB、LDH、CTnI、MDA水平心脏复灌后明显低于Ⅱ组,而I组术后SOD水平要高于Ⅱ组;Ⅰ组心律失常发生率、除颤次数明显低于Ⅱ组;术后Ⅰ组心功能恢复优于Ⅱ组;血管活性药物使用量Ⅰ组低于Ⅱ组。结论丹参注射液对二尖瓣膜置换术病人心肌缺血再灌注损伤具有明显的保护作用。

Myocardial protective effect of Danshen injection in patients undergoing open heart surgery

Objective To evaluate the myocardial ischemia-reperfusion injury protective effect of Danshen injection during heart valve replacement surgery.Method Sixty patients requiring heart valve replacement were divided randomly into Danshen group(groupⅠn=30)and control group(groupⅡ n=30).CPB was set up routing.After anethesia the patients in GroupⅠ received intravenous Danshen in a dose of 0.2 ml/kg before operation and after heart reperfusion,while patients in Group Ⅱ received the same valume of balanced salt solution.Central venous blood was withdrawn to measure CK、CK-MB、CTnI、MDA、SOD at the following time points: before the operation(T0)、30 min after CPB(T1)、15min after the heart reperfusion(T2)、 6 hour(T3)、12 hour(T4)、24 hour(T5)after the operation.A series of clinical data were recored.Such as the incidence of spontaneous recovery of heart beat after aorta off-damping、ventricular arrhythmia、the CPB time and supplementary circulation time.Results The serum CK-MB、CTnI、MDA levels in groupI were lower than those of groupⅡ;SOD level of Group Ⅰ was higher than that of Group Ⅱ;the clinical indexes such as supplementary time and the incidence of arrhythmia in Group Ⅰ was much lower than that in Group Ⅱ.Conclusion Danshen injection can offer significintly protective effect on myocardium during heart valve replacement surgery.