rHuEPO预处理对非紫绀型先天性心脏病心内直视手术患者心肌的保护作用

目的探讨重组人促红细胞生成素（recombinant human erythropoietin，rHuEPO）预处理对非紫绀型先天性心脏病心内直视手术患者心肌的保护作用。方法选取我院2011年2月～2011年12月择期进行体外循环心内直视手术非紫绀型先天性心脏病患者40例，随机分为rHuEPO预处理组（A组，n=20）和临床对照组（B组，n=20）。A组自术前1周开始，隔日皮下注射rHuEPO 75IU／kg，共3次。两组其他处理方式相同。于术前及术后第3天检测两组患者红细胞计数（RBC）、血红蛋白含量（Hb）、红细胞压积（Hct）及血小板计数（Pit），分别于术前及主动脉阻断开放后第1、3、6、12、24h这6个时间点检测血清肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、肌钙蛋白I（cTnI）、高敏感度C反应蛋白（hs—CRP）和同型半胱氨酸（Hcy）水平。结果两组术前及术后3天RBC、Hb、Hct及Pit变化不明显（P〉0．05）。A组在主动脉开放后各时间点CK、CK—MB、cTnI、hs—CRP、Hey明显低于B组，差异有统计学意义（尸〈O．05）。结论rHuEPO预处理能减轻非紫绀型先天性心脏病心内直视手术患者的心肌损伤，具有一定的心肌保护作用。

Myocardial protection effects of recombinant human erythropoietin preconditioning on the acyanotic congenital heart disease patients undergoing intracardial surgery

Objective To study-the myocardial protective effects of recombinant human erythropoietin （rHuEPO）preconditioning on acyanotic congenital heart diseases patients undergoing intracardial surgery with extracorporeal circulation. Methods 40 patients with acyanotic congenital heart disease in our hospital from Feb 2011 to Dec 2011 were randomly divided into rHuEPO pretreatment group （group A, n=20）and clinical control group （group B, n=20）.A group was administrated rHuEPO 75IU/kg,qod for 3 times before surgery,other experimental conditions were the same in two groups. RBC,Hb,Hct and Pit was detected before operation and 3 days after operation. Before operation and after aortic declamping and （Tx） lh （T2）,3h（T3）,6h （T4）, 12h（Ts） and 24h（Ts）of CK, CK-MB, cTnI, hs-CRP and Hcy were tested. Results RBC,Hb,Hct and Pit had no significant difference between before and after operation （P〉O.05）. The level of CK, CK-MB,cTnI,hs-CRP and Hcy reduced sig- nificantly in group A compared with group B after the aortic declamping（P〈0.05）. Conclusion Preconditioning of rHuEPO can reduce myocardial injury in acyanotic congenital heart diseases patients undergoing intracardial surgery with extracorporeal circulation, it has the obvious myocardial protection effects.