牛磺酸对体外循环手术病人心肌保护作用的基础与临床初步研究

The effects of taurine on myocardial pretection during cardiopulmonary bypass; experimental and clinical studies

本研究在离体大鼠心肌缺血一再灌注模型上和体外循环(CPB)心内直视手术病人应用牛磺酸后,观察牛磺酸对CPB手术病人的血浆内皮素(ET)、血管紧张素Ⅱ(AⅡ)和脂质过氧化代谢产物丙二醛(MDA)变化的影响.提示:①动物模型上用牛磺酸组较对照组心律失常发生机会少,左心室收缩力(LVEC)和土左室内压变化速率(LVdp/dt max)较对照组升高,左室舒张峰压(LVPDP)和冠脉灌流压(CPP)显著降低,心肌组织内蛋白漏出和MDA含量均明显减少;②用牛磺酸组ET含量较对照组低(P<0.01).在CPB的前4个阶段,AⅡ在两组中的变化规律相似,但用牛磺酸组的AⅡ水平较对照组低(P>0.05),术后24小时,用牛磺酸组AⅡ明显低于对照组(P<0.05);③在用牛磺酸组的各个阶段,MDA含量明显较对照组低(P<0.05或P<0.01).证明牛磺酸确对心肌细胞具有保护作用,指出体外循环前后应用牛磺酸是有益处的.

The effects of taurine on plasma endothelin (ET) ,angiotensin (AII) and malonyldialdehyde (MDA) during reperfusion following ischemia were studied in isolated perfused rathearts and in patients with open heart surgery under CPB. The results indicated that: (1)LVEC,LV dp/dt max in experimental group were significantly higher than those in control group.LVPDP ,CPP and MDA were decreased in experimental group. The occurrence of arrhythmias waslow in taurine perfused group. (2)In taurine treatment group ,the plasma level of ET was lowerwhen compared with that in control group. During CPB,changes of All were similar in two groupsand 24 hour after operation, AII was much higher in taurine treated group. (3)the MDA contentwas lower in taurine treated group when compared with that in control group. The study suggestedthat taurine had pretective effect on myocardial cells and taurine treatment during CPB was an important measure to prevent myocardial reperfusion injury.