盐酸戊乙奎醚对体外循环下成人心脏手术缺血再灌注心肌的影响

【目的】探讨盐酸戊乙奎醚（PHC）对成人体外循环下心脏瓣膜置换术（CPB-VR）缺血再灌注心肌的保护作用。【方法】成人择期行CPB-VR术患者40例，随机分为PHC组（P组）和对照组（C组），每组20例。麻醉诱导前10rain分别静注PHC0．02mg／kg和等体积生理盐水。于手术切皮即刻P组给予PHC0．02mg／kg，C组给予同等体积生理盐水。分别于入室后麻醉诱导前（T1）、术毕即刻（T2）、术后24h（T3）、术后48h（T4）测定血清肌钙蛋白（cTn-I）、肌酸激酶同工酶（CK—MB）的浓度。【结果】在T1时两组患者血清cTn-I、CK—MB浓度均在正常范围，且组间比较差异无统计学意义（P〉0．05）。与T1相比，P组和C组在T2、T3、T4血清cTn-I、CK—MB浓度均升高（P〈0．05），而且P组在T2、T3、T4时刻血清cTn-I浓度均低于C组各对应时刻的血清浓度（P〈0．05）；其中在T2、T3时刻，P组血清cK—MB浓度与C组同时刻相比，P组低于C组在同时刻的血清浓度（P〈0．05）；T4时两组血清肌CK—MB浓度与T2、T3相比均下降，且P组与C组组间比较差异无统计学意义（P〉0．05）【结论】PHC对CP昏VR缺血再灌注心肌有保护作用。

Effect of Penehyclidine Hydrochloride on Myocardial Ischemia-reperfusion Injury in adults under Cardiopulmonary Bypass

Objective]To explore the protective effect of penehyclidine hydrochloride（PHC） on myocardial ischemia-reperfusion injury（IRI） in adults during valve replacement surgery with cardiopulmonary bypass （CPB-VR）. Methods] Forty patients scheduled for CPB-VR were randomly divided into PHC group（group P, n =20） and control group（ group C, n =20）. All patients were given intravenous injection with 0.02mg/ kg PHC and the same volume of normal saline before anesthesia induction, respectively. Group P was given PHC 0.02mg/kg and group C was given the equal volume of normal saline immediately at surgical skin incision. Serum cardiac troponin-I（cTn-I） and creatine kinase-MB（CK-MB） were measured before induction of anesthesia（T1 ）, immediately in the end of operation（T2）, 24h（T3 ） and 48h（T4 ） after operation. Results] Serum levels of cTn-I and CK-MB in both groups at T1 were normal, and there was no significant difference be- tween two groups（ P 〉0.05）. Compared with T1, serum levels of cTn-I and CK-MB in two groups at T2, T3 and T4 elevated（ P d0.05）, and serum levels f cTn-I and CK-MB in group P were lower than those in group C at the three corresponding times（ P d0.05）. At Tz and T3, serum CK-MB in group P was lower than that in group C（ P〈0.05）. Compared with T2 and T3, serum CK-MB in two groups at T4 decreased, but there was no significant difference between two groups（ P〉0.05）. Conclusion]PHC has protective effect on myocardial IRI under CPB-VR.