牛磺酸对体外循环手术患者心肌保护作用的基础与临床初步研究

本研究在离体大鼠心肌缺血－再灌注模型上和体外循环心内直视手术病人应用牛磺酸后，观察牛磺酸对体外循环手术病人的血浆内皮素、血管紧张素Ⅱ和脂质过氧化代谢产物丙二醛变化的影响。提示：①动物模型上用牛磺酸组较对照组心律失常发生机会少，ＬＶＥＣ和±ＬＶｄｐ／ｄｔｍａｘ较对照组升高，ＬＶＰＤＰ和ＣＰＰ显著降低，心肌组织内蛋白漏出和丙二醛含量均明显减少；②用牛磺酸组内皮素含量较对照组低（Ｐ＜０．０１）。在体外循环前４个阶段，血管紧张素Ⅱ在两组中的变化规律相似，但术后２４小时，用牛磺酸组血管紧张素Ⅱ较对照组为低；③在用牛磺酸组的各个阶段，丙二醛含量明显较对照组低（Ｐ＜０．０５或Ｐ＜０．０１）。证明牛磺酸对心肌细胞具有保护作用，指出体外循环前后应用牛磺酸是有益处的。

The Effects of Taurine on Myocardial Protection During Cardiopulmonary Bypass:Experimental and Clinical studies

The effects of taurine on plasma endothelin(ET),angiotension(AⅡ)and malonyldialdehyde(MDA) during reperfusion following ischemia was studied in isolated perfused rat hearts and in patients undergoing open heart surgery under CPB. The results indicated that:(1) LVEC,LV dp/dt max in experimental group were significantly higher than those in control group.LWDP, CPP and MDA were decreased in experimental group.The occurrence of arrhythmias was low in taurine perfused group.(2)In taurine treated group,the plasma level of ET was lower when compared with control group.During CPB,changes of AⅡwas similar in two groups. 24 hours after operation AⅡ was much lower in taurine treated group.(3)The MDA content was lower in taurine treated group when compared with control group.The study suggested that taurine has protective effect on myocardial cells and taurine treatment during CPB is a beneficial mearsure to prevent myocardial reperfusion injury.