丹参酮Ⅱ-A磺酸钠注射液在体外循环中对心肌缺血/再灌注损伤保护作用的研究

目的研究丹参酮Ⅱ-A磺酸钠注射液在体外循环中对心肌缺血／再灌损伤的保护作用。方法随机选取20例行心脏直视手术的患者，分为对照组和丹参酮Ⅱ-A磺酸钠注射液组。丹参酮Ⅱ-A磺酸钠组于转机前给予丹参酮Ⅱ-A磺酸钠注射液2mg／kg。分别于主动脉插管后（T1）、开放主动脉前1-3min（T2）、主动脉开放后30min（T3）、主动脉开放后120min（T4），主动脉开放后720min（B）共5个时间点进行抽血，测定血清中超氧化物歧化酶（SOD）、丙二醛（MDA）含量；记录主动脉开放至心脏复跳所需时间，心律失常（室速／室颤）的发生率和持续时间。血清中超氧化物歧化酶、丙二醛采用分光光度法测定。结果两组患者围术期血清SOD浓度变化比较：对照组各时间点SOD的变化差异无统计学意义（P〉0．05），丹参酮Ⅱ-A磺酸钠组SOD浓度逐渐上升，在T4时间点达最高值（P〈0．05），T5时间点下降；组间比较，丹参酮Ⅱ-A磺酸钠组在T4时间点较对照组高（P〈0．05）。两组患者血清MDA浓度变化比较：对照组MDA浓度随时间点的推进逐步增高，于T4达最高值（P〈0．05），丹参酮Ⅱ-A磺酸钠组MDA浓度也逐渐升高，在T4时间点达高峰，B时间点下降，两时间点与T1比较差异有统计学意义（P〈0．05），组间比较，T4、L时间点差异有统计学意义（P〈0．05），丹参酮Ⅱ-A磺酸钠组比对照组MDA的上升幅度小。两组患者心律失常的发生情况比较：对照组共出现室颤2例，占20％，室速1例，占10％，丹参酮Ⅱ-A磺酸钠组出现室颤1例，无室速发生；对照组室速室颤持续时间3min，电击除颤后转为窦性心律，丹参酮Ⅱ-A磺酸钠组室颤后36s自动转为窦性心律。主动脉开放至心脏复跳所需时间：对照组所需时间较丹参酮Ⅱ-A磺酸钠组明显较长，差异有统计学意义（P〈0．05）。结论在体外循环心脏直视手术中，临床剂量的丹参酮Ⅱ-A磺酸钠注射液能使患者血清中的SOD浓度升高，有效降低MDA的浓度，缩短主动脉开放至心脏复跳所需时间，减少心律失常的发生率并缩短其时间，提示丹参酮Ⅱ-A磺酸钠注射液对心肌缺血／再灌注损伤有保护作用。

The protective effects of Sulfotanshinone Sodium injection on myocardial ischemia/reperfusion injury in cardiopulmonary bypass

Objective To study the protective effects of Sulfotanshinone Sodium injection on myocardial ischemia/reperfusion injury in cardiopulmonary bypass （CPB）. Methods Twenty patients undergoing cardiopulmonary bypass heart surgery were randomly divided into two groups, control group（C group, 10 cases） and Sulfotanshinone Sodium group （STS group, 10 cases）. Before CPB, the STS groups were treated with STS 2 mg/kg by intravenous injection. Blood samples were obtained after aortae intubation, 1 to 3 minutes before opening aortae, and 1/2 h and 2 h and 12 h after opening aortae. Then plasma levels of superoxide dismutase （SOD）, maleic dialdehyde （MDA） were measured, the time between opening aortae and resuscitation, incidence rate of arrhythmia were record. Results Activity of SOD were higher in STS group than control group at T4 （P〈0.05）. Content of MDA in STS group was markedly lower than those in control group at T4 and T5 （P〈0.05） after myocardial ischemia/reperfusion injury. The duration of return and ventricular arrhythmia in STS group are shorter than those in control group. Conclusion Sulfotanshinone Sodium injection shows some protective effects on myocardial ischemia/reperfusion injury in open heart surgery during CPB.