1,6-二磷酸果糖在肺手术围术期的心肌保护作用

Effect of fructose-1,6-diphosphete on myocardial preservation during pulmonary operations

目的:观察1,6-二磷酸果糖(FDP)在肺手术围术期对患者的心肌保护作用。方法:选择行择期单侧肺叶或肺段切除术患者106例,分为FDP组和对照组,每组53例。FDP组于麻醉前给予FDP 200 mg/kg,对照组给予等量5%的葡萄糖注射液。监测麻醉前至术毕72 h的心电图,记录心律失常发生的时间及类型,并于麻醉诱导后手术前(T0)、术毕即刻(T1)、术后24 h(T2)、48 h(T3)及72 h(T4)抽血测肌酸激酶同工酶MB(CK-MB)及心肌肌钙蛋白I(cTnI)浓度变化。结果:FDP组共发生心律失常35例次,明显少于对照组67例次。组间比较各类型心律失常发生例次FDP组均显著低于对照组,麻醉后至术毕、术后24 h内、术后24 h至48 h及术后48 h至72 h 4个时间段FDP组心律失常发生例次均少于对照组。FDP组CK-MB及cTnI浓度在T1,T2,T3和T4均显著低于对照组(P<0.05)。结论:FDP在肺手术围术期能产生有效的心肌保护作用。

Objective To investigate the effect of fructose-l, 6-diphosphete （FDP） on myocardial preservation in pulmonary operations. Methods One hundred and six patients undergoing selective pulmonary lobectomy or segmentectomy were randomly divided into 2 groups with 53 patients each. FDP 200 mg/kg was infused intravenously before anesthesia in the FDP group, while 5% glucose with the same volume was given instead of FDP in the control group. ECGs were monitored from before the anesthesia to 72 h after the operation;the time and type of arrhythmia were recorded. Blood samples were taken before the operation （ To ） , immediately after the operation （ T1 ） , at 24 h （T2 ）,48 h（T3 ）and 72 h（ T4 ） after the operation to determine plasma creatine kinase isoenzyme MB （CK-MB） and cardiac troponin I （cTnI） concentrations. Results The incidence of arrhythmia in FDP group （35 times） was significantly lower than that in the control group （67 times）. The incidence of all types of an-hythmia in the FDP group was also significantly lower than that in the control group. The concentrations of CK-MB and cTnI in the FDP group were significantly lower than those in the control group at T1 , T2 , T3 , and T4. Conclusion FDP is effective for myocardial preservation in pulmonary operations.