生脉注射液对心肌缺血与再灌注损伤的保护作用

Protective effects of Shengmai injection on myocardial ischemic reperfusion injury

目的:研究生脉注射液在体外循环术中作为心脏冷停搏灌注液的添加剂使用,对抗体外循环术中心肌缺血性损害及预防再灌注损伤的作用。方法:心脏手术患者6 0例,随机分为实验组(30例)和对照组(30例)。实验组患者心脏冷停搏液中加入生脉注射液。测定两组患者血清肌酸磷酸激酶(CK- MB)及超氧化物歧化酶(SOD)活性,电镜下观察心肌超微结构变化。结果:实验组患者血清CK- MB明显低于对照组(P<0 .0 5 ) ,SOD明显高于对照组(P<0 .0 5 )。线粒体形态计量分析,实验组线粒体面数密度及比表面明显高于对照组(P<0 .0 5 ,P<0 .0 1)。结论:生脉注射液在体外循环心内直视手术时作为心脏冷停搏液的添加剂使用,能保护细胞膜结构的完整性及稳定性,清除氧自由基,保护心肌超微结构,对减轻术中心肌损害有明确的治疗作用。

Objective To study the effects of Shengmai injection on alleviating myocardial ischemia and preventing the reperfusion injury when it was applied as the additive of the perfusion liquid in the process of cardiac surgery with cardiopulmonary bypass (CPB).Methods Sixty cardioetomy patients were randomly divided into experimental group (n=30) and control group (n=30). In the experimental group, the Shengmai injection was added to the reformative Thomas solution.The serum CK-MB and SOD levels were determined in experimental and control groups.The changes of myocardial ultrastuctures were observed under electron microscope. Results The level of CK-MB was significantly lower in the experimental group than that in the control group(P<0.05 ).The level of SOD in experimental group was significantly higher than that in the control group(P<0.05).The result of mitochondria morphological measurement indicated that the mitochondrial face number density and specific surface were significantly higher in the experimental group than those in the control group (P<0.05 or P<0.01). Conclusion Shengmai injection acted as the additive of the the cold stopping-pulse solution could protect the myocardial membrane and the ultrastructure of myocardium and debate the damage in the cardioetomy and eliminate the oxygen free radical.