乌司他丁对法洛氏四联症根治术体外循环期间cTnI、CK及CK-MB的影响

目的探讨乌司他丁对法洛氏四联症体外循环期间心肌损伤的防护作用。方法 142例法洛氏四联症根治术患者随机分入对照组（A组）和乌司他丁组（B组）,B组给予乌司他丁1.2万U/kg,A组以生理盐水代替。于麻醉诱导后即CPB前（T1）、CPB开始30min（T2）、开放主动脉30min（T3）、CPB停止6h（T4）和24h（T5）抽取动脉血测定血清心肌肌钙蛋白I（cTnI）浓度及CK、CK–MB活性,记录升主动脉阻断时间、CPB时间。结果两组CPB开始前血清cTnI浓度及CK、CK-MB活性均在正常范围,组间比较差异无统计学意义。A、B两组血清cTnI浓度及CK、CK–MB活性在T2～T5时间点显著升高（P〈0.05）;B组T3～T5时点的血清cTnI、CK和CK-MB值低于A组相同时点值,差异有统计学意义（P〈0.05）;B组T5时间点血清cTnI、CK、CK-MB值比T4时间点明显降低（P〈0.05）。结论乌司他丁可降低法洛氏四联症根治术CPB期间血清cTnI、CK及CK-MB的表达,起到心肌损伤保护的作用。

Effect of Ulinastatin on cTnI, CK and CK-MB Underwent open-heart Surgery on Tetralogy of Fallot with Cardiopulmonary Bypass

Objective To investigate the cardiac protective effect of ulinastatin of tetralogy of Fallot （TOF） during radical surgery with cardiopulmonary bypass （CPB）. Methods Scheduled for 142 TOF adical surgery patients with randomized, double-blind method is divided into 2 groups （n=71）： control group （A group） and ulinastatin（UTI） group （B group）. B group received UTI 12 000 U/kg, A group such as saline alternative UTI. Arterial blood samples were taken before CPB （T1）, 30 minut after a CPB （T2）, 30 minut after aortic release （T3）, 6h and 24 h after discontinuation of CPB （T4,TS） for determination of plasma levels of cardiac troponin-I （cTnI）, creatine kinase （CK） and creatine kinase isoenzyme MB （CK-MB）. Results Compared with A and B group ,The plasma cTnI level and CK and CK-MB activities were within normal range before CPB in both groups. In groups A and B cTnl level and CK and CK-MB activity was significantly higher （P〈0.05） at T2-T5, In group B cTnI level and CK and CK-MB activity at T3-T5 were significantly lower than in group A（P〈0.05）. cTnI level and CK and CK-MB activity at T5 were significantly lower than T4 In group B. Conclusion Ulinastatin reduce TOF patients＇ myocardial injury in open heart surgery with CPB.