异氟醚对非体外循环冠脉搭桥手术患者CK、CK-MB及cTnI的影响

Effects of isoflurane on the patients CK、CK-MB and cTNI underwent offpump coronary artery bypass

目的:观察异氟醚对非体外循环冠脉搭桥患者肌酸激酶(creatine kinase,CK)、肌酸激酶同工酶(creatine ki-nase-MB,CK-MB)以及心肌肌钙蛋白I(cardiac troponin I,cTnI)的影响,探讨其心肌保护作用机制。方法:将42例非体外循环冠脉搭桥患者随机分为异氟醚组和丙泊酚组,每组各21例。分别于术前、术后6h、术后12h和术后24h抽取静脉血,测定CK、CK-MB和cTnI。结果:两组术前CK比较,差异无统计学意义。异氟醚组CK于术后6h、术后12h和术后24h分别低于丙泊酚组(P<0.01)。两组术前CK-MB比较,差异无统计学意义。异氟醚组CK-MB于术后6h、术后12h和术后24h分别低于丙泊酚组(P<0.01)。两组术前cTnI比较,差异无统计学意义。异氟醚组cTnI于术后6h、术后12h和术后24h均低于丙泊酚组(P<0.01)。结论:异氟醚可降低非体外循环冠脉搭桥患者CK、CK-MB和cTnI的释放,是一种安全有效的麻醉药物。

Objective： To observe the effects of isoflurane on serum level of the patients, CK,CK-MB and cTnI underwent off-pump coronary bypass, and discuses the mechanism of the protection on myocardium. Methods： Forty-two patients who underwent OPCAB randomly divided into isoflurane group and propofol group, and 21 patients in each group. To draw vein blood preoperative, postoperative six hours, postoperative twelve hours and postoperative twenty-four hours for analyze CK, CK-MB and cTnI. Results：There was no significant difference between two groups of serum level of CK before surgery. The serum level of CK of isoflurane group was lower than propofol group after surgery six hours,twelve hours and twenty-four hours, respectively （P〈0.01）. No significant difference between two groups of serum level of CK-MB before surgery. The serum level of CK-MB of isoflurane group was lower than propofol group after surgery six hours,twelve hours and twenty-four hours, respectively （P〈0.01）. No difference between two groups of serum level of cTnI before surgery. The serum level of cTnI of isoflurane group was lower than propofol group after surgery six hours,twelve hours and twenty-four hours, respectively （P〈0.01）. Conclusion： Isoflurane may reduce the release of the serum level of CK,CK-MB and cTnI of the patients underwent OPCAB. Isoflurane is a safe and effective anesthesia agent.