胸腔镜心脏手术中应用参麦注射液防治体外循环心肌缺血再灌注损伤的临床研究*

Efficacy of Shenmai injection on the myocardial ischemia-reperfusion injury in patients underwent thoracoscopic cardiac surgery*

摘要:

摘要：目的  研究参麦注射液在体外循环（CPB）胸腔镜心脏手术中对心肌缺血再灌注损伤的保护作用。方法 将在CPB下的胸腔镜心脏手术的18例先天性心脏病患儿随机分为两组（每组9例），对照组和试验组。对照组不给药，试验组给予参麦注射液（2 ml/kg心脏冷停搏液中添加入参麦注射液）。分别于麻醉诱导后（T1）、心脏复跳后（T2）时间点测定样本中血清中以下指标的水平：肌钙蛋白T（cTnT）、肌酸激酶同工酶质量（CK-MB）和肌红蛋白（Mb），并测定心脏左室射血分数（EF）。结果 两组血清中cTnT、CK-MB和Mb的浓度都是在心脏复跳后与麻醉诱导后相比有明显的增加（P <0.05）；在心脏复跳后时间点参麦注射液组的cTnT、CK-MB和Mb明显低于对照组，而EF明显高于对照组（P <0.05）。结论 参麦注射液可以在CPB下胸腔镜心脏手术中对心肌缺血-再灌注损伤有保护作用。

Abstract:

Abstract: Objective To study the protective effect of Shenmai injection on myocardial ischemia reperfusion injury in patients underwent thoracoscopic cardiac surgery during cardiopulmonary bypass (CPB). Methods 18 patients with congenital heart disease with CPB thoracoscopic cardiac surgery were randomly divided into two groups (9 cases in each group): controlled group and experimental group. The controlled group did not give any intervened drugs, and the experimental group gave the injection of Shenmai that were added into heart cold cardioplegia (2 ml/kg).
The levels of the following indexes in the serum were respectively measured just after the time of induction of anesthesia (T1) and heart resuscitation (T2): Troponin T (cTnT), Creatine kinase isoenzyme (CK-MB) quality, myoglobin (Mb). And at the same time, the left ventricular ejection fraction (EF) was measured. Results The concentrations of cTnT, CK-MB and mb in the serum of both groups just after the time of heart resuscitation (T2) were significantly increased more than just after the time of induction of anesthesia (T1) (P < 0.05). But the concentrations of cTnT, CK-MB and Mb in the experimental group were significantly lower than that in the controlled group just after the time of cardiac resuscitation. And EF was significantly higher than the controlled group (P < 0.05). Conclusion Shenmai injection can protect the myocardium from ischemia-reperfusion injury in patients underwent thoracoscopic cardiac surgery during cardiopulmonary bypass (CPB).