磷酸肌酸钠对行腹部手术老年冠心病患者心肌保护作用的评价

目的：观察磷酸肌酸钠对老年冠心病患者动脉血氧分压、心肌酶及心律失常的影响。方法：选择60例ASAⅡ-Ⅲ级，行腹部手术的冠心病患者，随机分为对照组和实验组。实验组麻醉后使用磷酸肌酸钠，对照组使用生理盐水。两组分别在麻醉后、术后1h、术后2h及术毕时行血气分析观察动脉血氧分压的变化，于术后24h检测磷酸肌酸激酶同工酶（CPK—MB）和乳酸脱氢酶（LDH）水平。记录围术期Ⅱ导联心电图室性心律失常的发生情况。结果：与对照组相比，实验纽术中1h、术中2h和术毕动脉血氧分压明显提高；术后24h心肌酶较术前均升高，但实验组上升幅度较对照组明显减少；围术期实验组室性心律失常的发生率为10％，明显低于对照组。结论磷酸肌酸钠能提高老年冠心病患者围术期的动脉血氧分压，心肌酶得到明显改善，减少室性心律失常的发生，具有明显的心肌保护作用。

Evaluation of Creatine Phosphate Sodium on Myocardial Protection Effects of Senile Patients with Coronary Heart Disease

Objective To investigate the effects of creatine phosphate sodium on arterial oxygen partial pressure, cardiac enzymes and arrhythmias in senile patients with coronary heart disease. Methods Sixty patients with coronary heart disease, ASA Ⅱ-Ⅲ, were scheduled for abdominal surgery. All the patients were randomly divided into two groups as control group and study group. Creatine phosphate sodium and normal saline were intravenously given to study group and control group after anesthesia respectively. Arterial oxygen partial pressure was observed after anesthesia, 1 and 2 hour during the operation and at the end of surgery through arterial blood gas analysis in the patients. Isoenzyme of creatine phosphokinase - MB （ CPK - MB） and lactate dehydrognnase（LDH） levels were tested 24 hours post -operation. Ⅱ-lead electrocardiogram were re- corded to monitor ventricular arrhythmia perioperatively. Results Compared with control group, there was a significant increase in arterial oxygen partial pressure of study group I and 2 hour during the operation and at the end of surgery. The cardiac enzyme levels increased in all patients, but the amplitudes were significantly lower in study group. The incidence of perioperative ventricular arrhythmia in study group was 10%, which was significantly lower compared with control group. Conclusions Creatine phosphate sodium can effectively increase the arterial oxygen partial pressure, decrease the cardiac enzyme levels and reduce ventricular arrhythmia in perioperatlve senile patients with coronary heart disease, have significant effect on myocardial protection.