复方丹参对体外循环患者血清内皮素和血栓素水平的影响

Effect of salvia miltiorrhiza compound on production of endothelin and thromboxane in patients undergoing CPB

目的:观察复方丹参(SMC)对体外循环(CPB)下心肌缺血再灌注血清内皮素(ET),血栓素(TXB_2)和6-keto—PGF_(1α)(PGF_(1α))变化的。方法:20例先天性心脏病室缺(VSD)、房缺(ASD)修补患者随机分为对照组(组Ⅰ,10例)及复方丹参组(组Ⅱ,10例)。组Ⅱ于切皮前30分与复温时至心脏复跳前,分别静脉滴注SMC200mg/kg。组Ⅰ在同一时间给予等量平衡盐液。两组于术前(T_0),CPB后5分(T_1),心肌缺血30分(T_2),再灌注后10分(T_3)、30分(T_4),停CPB后30分(T_5),术后24小时(T_6),经中心静脉抽血样,分别测ET,PGF_(1α)和TXB_2浓度。结果:两组再灌注期血清ET较缺血期明显增加,组Ⅱ再灌注后T_4、T_5及T_6的ET值显著低于组Ⅰ(P<0.05)。再灌注后两组血清PGF_(1α)逐渐下降,而组Ⅰ的TXB_2呈上升趋势,组Ⅱ的TXB_2在T_4、T_5、T_6又下降,各期值显著低于组Ⅰ(P<0.01)。结论:SMC能显著降低再灌注期ET、TXB_2的产生,从而促进CPB后心功能的恢复。

Objective: To observe the effects of salvia miltiorrhizae compound (SMC) on serum endothelin (ET), TXB_2 and PGI_2 levels in patients undergoing CPB. Method: Twenty patients with congenital heart disease were randomly divided into control group (group Ⅰ) and treated group (group Ⅱ). SMC (200mg/kg) were given intravenously in group Ⅱ before operation and during rewarming, in group Ⅰ eqivalent volumes of normal saline were administered at the same time point. The serum ET,TXB_2 and PGI_2 levels were measured at preoperation (T_0) 5min (T_1), and 30min (T_2) following CPB, 10min (T_3), 30min (T_4) and 60min (T_5) following reperfusion, 24h (T_6) after operation. Result: In both groups,the serum ET level were increased significantly during reperfusion, but much less in group Ⅱ than that in group Ⅰ at T_4, T_5 and T_6(P<0.05). The serum PGI_2 of both groups were decreased continuously during reperfusion. The TXB_2 level was increased in group Ⅰ but decreased in group Ⅱ at T_4, T_5 and T_6. The postoperative cardiac function recovered much more better in group Ⅱ than in group Ⅰ. Conclusion: SMC can reduce dramatically the production of ET and TXB_2 during reperfusion to improve cardiac function recovery after CPB.