注射用环磷酸腺苷在肝移植手术中对心肌酶的影响

Effects of adenosine cyclophosphate on myocardiac enzymes in patients undergoing orthotopic liver transplantation

目的观察肝移植手术中静脉泵入注射用环磷酸腺苷(美心力,cAMP)对心肌酶的影响,探索肝移植手术中减少心肌损伤的可行途径。方法40例肝移植手术患者,随机分为对照组和美心力组,均于游离第二肝门时开始,分别经静脉微量泵泵入等量生理盐水和美心力2.0 mg/(kg.h),至新肝期2 h后停止。各时间点分别静脉采血检测肌酸磷酸激酶(CPK)、肌酸磷酸激酶同工酶(CK-MB)。结果开放血流后,两组CPK、CK-MB均有所增加,但美心力组各时间点增加值均显著低于对照组(P<0.05)。结论肝移植手术中应用美心力能够在一定程度上减轻心肌损伤。

Objective To study the effect of adenosine cyclophosphate （cAMP） on myocardiac enzymes in patients undergoing orthotopic liver transplantation（OLT）, and to search for a feasible method of preventing and redncing myocardiac injury. Methods Forty patients undergoing OLT were randomly divided into two groups with 20 cases each： control group and cAMP group. The two groups were pumped intravenously with equal volume of saline and cAMP 2.0 mg/（kg·h） by micropump separately from the time of dissecting the second porta hepartis to 2 horns after the beginning of neohepatic phase. Results The CPK and CK - MB levels in the cAMP group were significantly lower than those in the control group. Conclusion cAMP can effectively reduce myocardiac injury to some extent.