摘要
目的比较组氨酸—色氨酸—酮戊二酸盐液(HTK液)与含血心脏停搏液对复杂冠状动脉病变合并左心功能不全心肌的保护作用。方法采用随机分组的方法将134例复杂冠状动脉病变合并左心功能不全的患者分为两组,每组67例,分别使用HTK液和含血心脏停搏液,比较两组手术前后血清心肌损伤标志物水平、钾、钠离子水平、心功能以及不良事件发生率。结果两组患者治疗前后以及主动脉开放12h、24h、72h肌钙蛋白、肌酸激酶同工酶、钾离子、钠离子、左心室射血分数、左心室收缩末期容积指数、左心室舒张末期容积指数等指标的差异具有统计学意义(P<0.05);两组患者主动脉阻断时间、主动脉开放到心脏复跳、体外循环时间、多巴胺用量比较差异有统计学意义(P<0.01);两组患者围术期不良事件发生情况差异有统计学意义(P<0.01)。结论 HTK液与含血心脏停搏液均可对复杂冠状动脉病变合并左心功能的不全的患者提供安全有效的心肌保护效果,但是HTK液的效果优于含血心脏停搏液,不良事件的发生率更低,安全性更高。
Objective To compare the protective effect of histidine-tryptophan-glutaric-acid（ HTK） liquid and blood cardioplegia in complicated coronary artery disease with left cardiac dysfunction. Methods 134 patients with left coronary artery lesions and cardiac insufficiency were randomly divided into two groups（ 67 cases in each group）,one using HTK liquid and the other using blood cardioplegia. Serum myocardial injury markers content,potassium,sodium ion content,cardiac function,and incidence of adverse events before and after operation were compared in two groups. Results Index as includingtroponin,creatine kinase isoenzyme,potassium,sodium,left ventricular ejection fraction,left ventricular end systolic volume index,left ventricular end-diastolic volume index before and after treatment,at12 h,24 h 72 h of aortic open in patients of two groups were statistically significant（ P 0. 05）. The aortic blocking time,time from aorta opening to the heart resuscitation,corporeal circulation time and the amount of dopamine of the two groups were statistically significant（ P 0. 01）. The differences of perioperative adverse events in the two groups were statistically significant（ P 0. 01）. Conclusions HTK liquid and blood cardioplegia can provide myocardial protective effect for patients with complex coronary artery lesions combined with left heart disfunction. The effece of HTK liquid is superior to blood cardioplegia,with lower incidence of adverse events and higher security.
作者
何勇
李中杰
陈冲
刘光强
游荣帆
曹勇
HE Yong;LI Zhong-jie;CHEN Ching(Gaozhou City People＇s Hospital of Guangdong Province,Guangdong 525200,China)
出处
《心脑血管病防治》
2018年第3期188-191,共4页
CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT
基金
广东省茂名市科技计划科研项目(编号:170516221702147)
