左-卡尼汀在心内直视手术中对心肌的保护作用 |
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引用本文: | 任明明,李敬来,韩振,程颖,吴永前.左-卡尼汀在心内直视手术中对心肌的保护作用[J].中国当代医药,2010,17(16):48-49. |
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作者姓名: | 任明明 李敬来 韩振 程颖 吴永前 |
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作者单位: | 北京大学深圳医院心血管外科,广东深圳,518036 |
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摘 要: | 目的:探讨心内直视手术中外源性左-卡尼汀(L-CN)对心肌的保护作用。方法:选取心内直视手术的患者32例,随机分为实验组和对照组。实验组术中于冷晶体心脏停搏液中按10g/L加入L—CN,行冠状动脉顺行灌注;对照组仅使用冷晶体停搏液灌注。两组均于术前、主动脉阻断开放后2、24、72h各时点采取静脉血,测心肌酶(CK、CK—MB),肌钙蛋白I(cTnI)和肌钙蛋白T(cTnT)水平。结果:两组患者CK、CK—MB,cTnT、cTnI水平在术前比较。差异无统计学意义(P〉0.05),于主动脉开放后均有明显的升高。实验组CK、CK—MB升高程度较对照组低(P〈0.05)。实验组cTnT、cTnI升高程度在2、24及72h较对照组低(P〈0.05),2h尤其明显(P〈0.01)。结论:在心内直视手术中。左-卡尼汀加入心脏停搏液后可明显改善心脏能量供应,有效减少心肌细胞损伤,对心肌起到明显保护作用。
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关 键 词: | 体外循环 心内直视手术 停搏液 左-卡尼汀 心肌保护 |
The myocardial protective effects of L-carnitine under open cardiac operation |
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Authors: | REN Mingming LI Jinglai HAN Zhen CHENG Ying WU Yongqian |
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Institution: | (Department of Cardiovascular Surgery, Peking University Shenzhen Hospital,Guangdong Province, Shenzhen 518036, china) |
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Abstract: | Objective:To investigate the myocardial protective effects of L-carnitine in patients with heart disease undergoing open cardiacoperation under cardio-pulmonary bypass(CPB).Methods:Thirty-two patients undergoing open cardiac- operation were randomly divided into test group(n=16) and control group(n=16). L-carnitine was put in the cold crystal cardiac arresting liquid in the test group(10 g/L), other experimental conditions were the same between two groups. Before operation,at 2,24,72 h after the aortic declamping, venous blood was drawn to test the level of serum ereatine kinase(CK),CK- MB isozyme,cardiac Troponin I(cTnI),eardiac Troponin T (cTnT). Results:The level of CK,CK-MB,cTnT,cTnI in blood samples increased indiffereneely in two groups before operation, increased significantly in two groups after the aortic declamp ing.The increase magnitude of CK,CK-MB in control group was more than test group (P〈0.05); The increase magnitude of cTnT, cTnI in control group was more than test group at 2,24,72 h after declamping, much more at 2 h (P〈0.01).Conclusion: L-carnitine improves the service of the energy in myocardium undergoing open cardiac operation under CPB obviously, decreases the damage of the ceils in myocardium effectly and has a good protective effect on myoeardium in patients. |
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Keywords: | Cardio-pulmonary bypass Open cardiac operation Cardioplegic solution Carnitine Myocardial protection |
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