1,6-二磷酸果糖在冠脉搭桥术中对心肌的保护作用

Protective effect of fructose-1,6-diphosphate on myocardium during coronary artery bypass graft

目的评估1,6-二磷酸果糖(fructose-1,6-diphosphate,FDP)在冠状动脉搭桥术中对心肌的保护作用。方法随机选取30例冠心病患者,分为实验组和对照组,每组15例。实验组于术前三天及手术当日给予FDP,对照组给予生理盐水。分别于麻醉诱导后(T0),再灌注后1 h(T1)、4 h(T2)、24 h(T3)及48 h(T4),测定血浆肌钙蛋白I(cardiactroponin I,cTnI)、肌酸激酶同工酶(creatine kinase MB,CK-MB)、超氧化物歧化酶(superoxide dismutase,SOD)及丙二醛浓度(malondiadehyde,MDA)。结果实验组于T1、T2、T3三个时点CK-MB及cTnI浓度均显著低于对照组(P<0.05),T1及T2两个时点MDA浓度明显低于对照组(P<0.05)。结论FDP能够减轻由脂质过氧化反应介导的心肌缺血再灌注损伤,有助于缺血再灌注后心功能的恢复及改善。

Objective To investigate the cardio-protective effects of fructose-1,6-diphosphate on myocardium during coronary artery bypass graft. Methods A total of 30 patients were treated with coronary artery bypass graft （CABG） and divided into group A （treated group） and group B （control group） randomly. Each group included 15 patients. In the treated group, patients were treated with FDP three days before CABG and treated with FDP before cardiopulmonary bypass （CPB）. FDP was replaced by 0. 154 mol/L NaCI of the same volume in control group. Blood samples were collected from all patients after induction and at 1h, 4h, 24h and 48h after aortic declamping to measure the serum concentration of cTnI, CK-MB, SOD and MDA. Results The levels of CK-MB and cTnI at lh, 4h, 24h and MDA at 1h, 4h after reperfusion were significantly lower in the treated group than those in the control group（P（0.05）. The concentration of MDA at T1 and T2 was significantly lower than that of the control group （P （0.05）. Conclusion FDP can effectively reduce myocardial ischemia repcrfusion injury caused by lipsupcroxidized reaction. Therefore, FDP has a desirable myocardial protective effect on patients undergoing CABG.