川芎嗪对体外循环下炎症反应和心肌缺血-再灌注损伤的保护作用

目的 探讨不同剂量川芎嗪对体外循环(CPB)所致炎症反应和心肌缺血-再灌注损伤(MIRI)的保护作用.方法 60例先天性房间隔或(和)室间隔缺损患者随机分为对照组(A组)、盐酸川芎嗪3 mg/kg组(B组)、9 mg/kg组(C组)、12mg/kg组(D组).分别于诱导后(T0)、转机后15 min(T1)、停机后2 h(T2)、停机后6 h(T3)、手术后24 h(T4)抽取静脉血测量血清中肿瘤坏死因子(TNF)、心肌肌钙蛋白Ⅰ(cTnI)的浓度,并观察血流动力学指标.结果 TNF的含量B、C、D组T2与A组相比有统计学差异,但是C、D两组的差异更加显著;整体上,C、D两组较A、B两组显著降低.cTnI的含量:A组cTnI的峰值出现在T4,C组T2、T3、T4与T1无统计学差异;C组T4时与A组相比具有显著差异;整体上,C组较A组降低.各组血流动力学指标无差异.结论 川芎嗪对体外循环(CPB)所致炎症反应和心肌缺血-再灌注损伤(MIRI)有保护作用,以9mg/kg作用较为显著.

Protective effect of ligustrazine on inflammatory reaction and myocardial ischemia-reperfusion injury during cardiopulmonary bypass

Objective To evaluate the protective effect of ligustrazine in different dosage on inflammatory reaction and myocardial ischemia-reperfusion injury induced by cardiopulmonary bypass(CPB).Methods Sixty patients with congenital atrial or(and)ventricular septum defect undergoing open heart surgery with CPB were divided into 4 groups at random:group A(control group);Ligustrazine groups,receiving Ligustrazine 3 mg/kg(B),9 mg/kg(C),12 mg/kg(D),respectively.Tumor necrosis factor(TNF)and cardiac troponin I(cTnI)were measured after induction(T0),at 15 min during CPB(T1),at 2 h(T2)and 6 h(T3)after CPB,at 24 h after operation(T4).All hemodynamic indices of these patients were recorded accordingly.Results TNF concentration was lower in groups B,C,D than in group A at T2,and significantly lower in group C,D than in group B.TNF concentration was significantly lower in groups C,D than in groups A,B as a whole.The cTnI concentration peaked at T4 in group A,whereas there was no significant difference between T1,T2,T3 and T4 in group C.The cTnI concentration had significant difference at T4 between group C and group A.The cTnI concentration was lower in group C than in group A as a whole.All hemodynamics indices had no significant difference among groups A,B,C and D.Conclusion Ligustrazine has protective effect on inflammatory reaction and myocardial ischemia-reperfusion injury induced by cardiopulmonary bypass(CPB),and 9 mg/kg ligustrazine is more effective.