静脉滴注银杏叶提取物对心脏直视手术心肌保护作用

Protective effects of intravenous injection of ginkgo biloba extract on myocardium in patients undergoing open heart surgery

目的研究静脉滴注银杏叶提取物(EGb)对心脏直视手术的心肌保护效应。方法30例择期行二尖瓣置换术患者,随机分为抑肽酶组(Ⅰ组)、EGb组(Ⅱ组)和对照组(Ⅲ组),每组10例。三组的麻醉方法均相同,分别在术前、主动脉开放即刻、开放后1、6、24h测定肌酸激酶同工酶(CK-MB)、超氧化物歧化酶(SOD)、丙二醛(MDA)及内皮素(ET)的浓度,同时分别记录各组的复跳时间、心内电击除颤次数、复跳后24h多巴胺的平均用量、心肺转流(CPB)时间、主动脉阻断时间、手术时间。结果三组患者在术后各时点CK-MB、SOD、MDA、ET浓度与术前相比差异有统计学意义(P<0.01),但Ⅱ组变化与Ⅰ组、Ⅲ组相比明显偏小;Ⅱ组的复跳时间、除颤次数及复跳后24h多巴胺的平均用量与Ⅰ组、Ⅲ组相比差异有统计学意义(P<0.05)。结论静脉注射EGb能够减轻心脏直视手术的心肌缺血-再灌注损伤,具有明显的心肌保护作用。

Objective The myocardial protective effects of injecting ginkgo biloba extract were studied during open heart surgery under cardiopulmonary bypass （CPB）. Methods Thirty patients scheduled for simple replacement of mitral valve were randomly divided into group Ⅰ （aprotinin group） ,group Ⅱ （EGb group） and group Ⅲ （blank group）. Anesthesia induction and maintenance were same in three groups. The central venous blood sample were collected to measure the concentrations of serum CK-MB, SOD, MDA, ET before operation,at declamping of the aorta, 1,6,24 h after reperfusion. The time of rebeating, CPB, blocking arteriae aorta and operation,the frequency of defibrillation and the average amount of dopamine were recorded. Results The times of CPB, blocking arteriae aorta and operation were not statistically different among three groups. The concentrations of CK-MB, SOD, MDA, and ET were significantly different after operation（P〈0.01）, those in group Ⅱ were obviously lower than those in group Ⅰ and group Ⅲ after operation. The time of rebeating, the frequency of defibrillation and the average amount of dopamine in group Ⅱ were less than those in group Ⅰ and Ⅲ （P〈0.05）. Conclusion Intravenous injection of ginkgo biloba extract can attenuate the myocardial damage of ischemic-reperfusion in patients undergoing open heart surgery.