注射用心肌肽在体外循环心内直视手术期间对患者心肌缺血再灌注损伤的保护作用

目的：通过观察注射用心肌肽在体外循环(CPB)心内直视手术期间的应用，阐明其对患者心肌再灌注损伤的防护作用。方法： 30例二尖瓣机械瓣置换患者，采用随机数字表方法分为实验组和对照组。实验组在术中及术后，给予注射用心肌肽。两组患者分别在体外转流前（T0）、主动脉开放即刻（T1）、主动脉开放后30 min(T2)、停止CPB 12 h（T3）、24 h（T4）抽取桡动脉血，检测肌酸激酶同功酶（CK-MB）、心肌肌钙蛋白I（cTnI）、血浆肿瘤坏死因α（TNF-α）的浓度。术后第7天测心脏射血分数（EF）。结果 ：两组患者体外转流前血浆CK-MB、cTnI 及TNF-α浓度比较差异无显著性（P>0.05）；开放30 min后两组患者血清CK-MB、TNF-α明显高于T1（P<0.05），且实验组在T2、T3、T4各相同时间点血清CK-MB、TNF-α浓度均明显低于对照组(P<0.05)；主动脉开放即刻两组患者血清cTnI明显升高，且实验组在T1、T2、T3、T4各相同时间点血清cTnI明显低于对照组（P<0.05）。术后7 d，实验组EF值明显高于对照组(P<0.05)。结论：在CPB心内直视手术术中及术后给予注射用心肌肽可明显减轻炎症反应、抑制心肌损伤，改善心功能。

Myocardium protection of cardiomyopeptide for injection against ischemia-reperfusion injury during open heart surgery with cardiopulmonary bypass

Objective To investigate the myocardium protection of cardiomyopeptide for injection against ischemia-reperfusion injury during open heart surgery with cardiopulmonary bypass(CPB).Methods Thirty patients scheduled for elective cardiac valvular replacement were divided into two groups.In treatment group(n=15), cardiomyopeptide for injection was used during CPB;but in control group(n=15),no cardiomyopeptide for injection was used.Blood samples were drawn from the radial artery at the following time points: be...