高氧液预处理在冠脉搭桥术中对心肌的保护作用

Protective effect of hyperoxia liquid preconditioning on myocardium during coronary artery bypass graft

目的:评估高氧液预处理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5天及手术当日给予高氧液,对照组给予复方氯化钠注射液。分别于麻醉诱导后(T0),再灌注后1h(T1)、4h(T2)、24h(T3)及48h(T4),测定血浆肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-M B)、超氧化物歧化酶(SOD)及丙二醛(MDA)浓度。结果:实验组于T1、T2、T33个时点CK-M B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,SOD浓度明显高于对照组(P<0.05)。术后24h多巴胺用量,实验组明显低于对照组(P<0.01)。结论:高氧液预处理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 hyperoxia liquid preconditioning 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） in random. Each group involves 15 patients. In the treated group, patients were treated with hyperoxia liquid five days before CABG and on the same day before cardiopulmonary bypass （CPB）. Hyperoxia liquid was replaced by Ringer＇s injection of the same volume in control group. Blood samples were collected from all patients after induction and at 1h,4h, 24h, 48h after aortic declamping to measure the serum concentration of cTnI,CK-MB,SOD,MDA. Result ： The levels of CK-MB,cTn at 1h,4h,24h and MDA at 1h,4h after reperfusion were significantly lower in the treated group than those of control group（P〈0. 05）. The concentration of SOD atlh,4h after reperfusion was higher than that of the control group （P〈0. 05）. The amount of dopamine in group A was lower than that of group B after aorta offclamping within 24 hours（P〈0.01） . Conclusions： Hyperoxia liquid preconditioning can effectively reduce myocardial ischemia reperfusion injury caused by lipsuperoxidized reaction. Therefore, hyperoxia liquid preconditioning has a desirable myocardial protective property in patients undergoing CABG .