乌司他丁对体外循环冠状动脉旁路移植术患者心肌保护作用

【目的】评价乌司他丁在体外循环冠状动脉搭桥手术中对心肌的保护作用,为临床应用提供理论依据.【方法】选取我院近年30例冠状动脉旁路移植术患者,按入院顺序随机分两组：观察组（A组）患者15例,术中术后使用乌司他丁,对照组（B组）15例,未使用乌司他丁.检验两组患者各时点血浆心肌肌酸激酶同工酶（creatinekinase-MB,CK-MB）活性和心肌肌钙蛋白I（cardiactrononinI,cTnI）的浓度,比较两组患者术后正性肌力作用药物使用量.【结果】两组无手术死亡.观察组较对照组患者心肌肌酸激酶同工酶（CK-MB）活性、心肌肌钙蛋白I（cTnI）的浓度及术后多巴胺[（76.4±13.6）、（117.5±12.4）h]、肾上腺素[（50.4±12.1）、（88.9±10.8）h]的使用量减低,差异有统计学意义（P〈0.01）.【结论】乌司他丁在体外循环冠状动脉旁路移植术中对患者心肌可起到明显保护作用.

Effects of ulinastatin on myocardial protection in patients with on-pump coronary artery bypass grafting

[Objective]To evaluate the potential myocardial protective effects of ulinastatin in patients undergoing on-pump coronary artery bypass grafting. [ Methods ]Thirty patients scheduled for elective coronary artery bypass graft surgery were randomly divided into uliastatin group （n = 15） and control group （n = 15）. Blood samples were drawn from the radial artery to determine the concentrations of creatine kinase-MB （CK-MB） and cardiac trononin I （cTnI） at the scheduled intervals. [Results]There was no operation death in both groups. Compared with control group, the plasma levels of CK-MB and cTnI were decreased in ulinastatin group at each time of scheduled intervals statistically （all P 〈0.05）. In addition, ulinastatin group was also associated with reduced positive inotropic drug usage duration of dopamine used： （76.4 ± 13.6） hours vs （117.5 ± 12.4） hours, epinephrine used：（50.4 ± 12.1） hours vs （88.9 ± 10.8） hours（P 〈 0.01）. [Conclusion] Perioperative usage of Ulinastatin may have myocardial protective effects on patients with on-pump coronary artery bypass grafting.