摘要
目的:探讨依达拉奉(edaravone,MCI-186)对行单一瓣膜置换手术患者心肌的保护作用。方法:32例风湿性心脏病患者随机分为两组,MCI-186组17例,对照组15例。依达拉奉组接受MCI-186 0.5 mg/kg在主动脉开放前10 min一次性加入体外循环机静脉储血罐中,对照组不接受MCI-186。分别于术前、主动脉开放后8,16,72 h测量血清肌酸激酶同功酶(creatine kinase Mbmass,CK-MB)、肌红蛋白(myoglobin,Myo)、心肌肌钙蛋白I(cardiac troponin I,cTnI),于术前、主动脉开放后4,8,16,24 h测量血浆丙二醛(malonaldehyde,MDA)水平。记录复跳和术后48 h正性肌力药物应用情况。结果:①CK-MB,cTnI在主动脉开放后8 h,Myo在主动脉开放后16 h最高;组间比较CK-MB,Myo,cTnI在主动脉开放后8 h,16 h依达拉奉组均低于对照组(P<0.01)。②MDA在主动脉开放后各时点均升高,依达拉奉组在开放后各时点均低于对照组(P<0.01)。③主动脉开放后心脏自动复跳率依达拉奉组高于对照组。术后48 h多巴胺平均最大剂量依达拉奉组少于对照组(P<0.05)。结论:在再灌注前,及时给予依达拉奉可减少MDA的产生,减轻心肌缺血再灌注损伤。
Objective: To investigate the myocardial protection effect of edaravone (MCI-186) in patients with single valve replacement. Methods: Thirty-two patients with rheumatic heart disease were randomly divided into two groups: MCI-186 group( group M, n = 17) received edaravone injection 0.5 mg/kg in venous blood reservoir of cardiopulmonary bypass unit at 10 min before declamping aorta, control group ( group C, n = 15 ) did not receive edaravone. Blood samples were taken before skin incision ( T1 ), and at 4 h( T2 ), 8 h ( T3 ), 16 h ( T4 ), 24 h ( T5 ) after declamping aorta for determination of MDA; at T1, T3, T4 and 72 h (T6) after declamping aorta for determination of CK-MB, Myo, cTnI. Meanwhile, the clinical effectiveness of the two groups was observed. Results: ①After declamping aorta, the levels of CK-MB, Myo, cTnI at T3, T4 in group M were lower than those in group C( P 〈0.01 ). ②The levels of MDA in group M were higher than in group C at all time points after declamping aorta(P 〈0.01 ). ③After declamping aorta, the spontaneous return rate was 60% in group C and 90% in group M. The amount of positive inotropic drugs in group M was less than group C(P 〈0.05). Conclusion: Before reperfusion, MCI-186 can decrease the production of MDA in order to reduce myocardium ischemic reperfusion injury if supplied in time.
出处
《江苏大学学报(医学版)》
CAS
2007年第2期161-163,共3页
Journal of Jiangsu University:Medicine Edition
关键词
依达拉奉
瓣膜置换术
丙二醛
心肌保护
缺血再灌注
edaravone
valve replacement
malonaldehyde
myocardial protection
ischemic reperfusion