二氮嗪对心脏直视术中心肌的保护作用

Myocardioprotective effects of diazozide on patients with ventricular septal defect during operation

目的:探讨ATP敏感性K+通道开放剂二氮嗪对先天性心脏病室间隔缺损手术中心肌的保护作用。方法:选择期行先天性心脏病室间隔缺损修复术的患者共50例,随机分成试验组和对照组。试验组于转流前通过颈内静脉插管直接将二氮嗪(2mg/kg)静脉注射到靠近右心房的上腔静脉,对照组静脉滴注同等体积的生理盐水。对比转流前、主动脉阻断后30min、60min、术后24h各时间点心肌肌钙蛋白T(cTnT)含量、磷酸肌酸激酶同工酶(CK-MB)水平及心肌超微结构变化(线粒体评分)。结果:试验组血清cTnT含量在主动脉阻断后30min、60min和术后24h,CK-MB水平在阻断后60min和术后24h均低于对照组(P<0.05),主动脉开放后30min试验组线粒体评分与对照组相比较差异有统计学意义(P<0.05)。结论:ATP敏感性K+通道开放剂二氮嗪可减轻先天性心脏病室间隔缺损手术心肌长时程低温缺血再灌注损伤。

Aim： To investigate the myocardioprotective effects of ATP sensitive potassium channel open medicine （ diazoside） preconditioning on patients with ventricular septal defect during operation. Methods：Fifty patients with ventricular septal defect were randomly divided into two groups ： treatment group and control group. Diazozide was given to the treatment group before the cardiopulmonary bypass. The changes in serum cTnT, CK-MB at different time points were Observed. The change in the ultrastructure of mitochondria was observed. Results： At 30 min, 60 min after closing the aorta and .7.4 h after operation, the cTnT in the treatment group was significantly lower than that in the control group （P 〈 0.05 ）. At 60 min after closing the aorta and 24 h after operation, CK-MB was lower than those in control group （P 〈0.05）. The rnitochondrial score in the treatment group was lower than that in the control group at 30 min after opening the aorta （ P 〈 0.05 ）. Conclusion： Diazozide preconditioning in patients with ventricular septai defect during operation can reduce isehemic-reperfusion injury.