摘要
目的:观察异氟醚预处理对体外循环下幼犬心内直视手术心肌的保护作用.方法:将20只幼犬,随机分为预处理组(Ⅰ组,n=10)和对照组(Ⅱ组,n=10),观察两组转机时间、主动脉阻断时间、心脏复跳情况、循环情况.分别于麻醉后(T1),体外循环主动脉开放后15min(T2),4h(T3),24min(T4)时间点取血样,检测血清降钙素基因相关肽(CGRP)、内皮素(ET),心钠素(ANP),心肌钙蛋白(cTnI)的变化.结果:两组转机时间、主动脉阻断时间、开放至复跳时间无统计学差异(P>0.05),Ⅰ组的自动复跳率、复跳后低血压发生率及术后24h低血压发生率均优于Ⅱ组(P<0.05).主动脉开放15min后,两组CGRP和ANP均增高(P<0.01),但Ⅰ组高于对照组(P<0.05);ET和cTnI在主动脉开放后也上升(P<0.01),但预处理组上升幅度低于Ⅱ组(P<0.05).结论:异氟醚预处理能减少心肌的缺血再灌注损伤,促进体外循环后心功能恢复.
AIM： To investigate the myocardial protective effects of pretreatment with isoflurane during open heart surgery in young dogs under cardiopulmonary bypass （CPB）. METHODS ： Twenty young canine undergoing cardiac operation were randomized into isoflurane preconditioning group （group Ⅰ , n = 10） and control group （ group Ⅱ , n = 10）. Blood samples were taken for the measurement of CGRP, ET, ANP and cTnI after anesthesia（ before CPB） ,at 15 min after aortic declamping and 4, 24 hours after the termination of CPB. The aortic clamping time and CPB time were recorded. The state of circulation and the heart spontaneous return were observed. RESULTS： There were no significant differences in duration of bypass, aortic cross clamping time and the time from aortic opening to resumption of heart beating between group Ⅰ and group Ⅱ （P 〉 0.05） . Incidence of spontaneous resuscitation was higher in group Ⅰ than in group Ⅱ （P 〈 0.05）. Incidence of hypotenion after resumption of heart beating and in the following 24 h were lower in group Ⅰ than in group Ⅱ （P 〈 0.05 ）. The CGRP and ANP levels of group Ⅰ , Ⅱ significandy increased at 15 min after aortic opening as compared with counterparts before CPB （ P 〈 0. 01 ）. But the CGRP and ANP levels of group Ⅰ were higher than the counterparts of control group（group Ⅱ ）. Compared with the concentrations of ET-1 and cTnI before CPB, the level increased significantly after aortic opening （ P 〈 0. 01 ）. However, the ET-1 and cTnI levels in group Ⅰ were lower than those in group Ⅱ （P 〈 0.05 ）. CONCLUSION： lsoflurane preconditioning could protect myocardium against injury during open heart surgery in young canine under cardiopulmonary bypass.
出处
《第四军医大学学报》
北大核心
2008年第13期1166-1168,共3页
Journal of the Fourth Military Medical University
基金
国家"十一五"科技支撑计划(2006BAI01A08)
