注射用复合辅酶对体外循环心肌的保护作用

The protective effect of coenzyme complex on myocardium undergoing cardiopulmonary bypass operation

目的探讨复合辅酶加预充液及心肌保护液对心脏瓣膜置换术中心肌损伤的保护作用及其机制。方法 30例心脏瓣膜病患者随机分成实验组和对照组各15例。对照组不给药,实验组在麻醉诱导后预充液及心肌保护液中加入复合辅酶,主动脉阻断前后不同时点采桡动脉血测定围术期肌钙蛋白-I(cTnI)、肌酸激酶同工酶(CK-MB)、丙二醛(MDA)、红细胞压积(HCT),停体外循环后15 min采右心房心肌组织,电镜下观察超微结构变化。结果主动脉开放后cTnI、CK-MB、MDA值显著升高,实验组显著低于对照组;超微结构示实验组心肌损伤明显轻于对照组。结论预充液及心肌保护液中应用复合辅酶可减轻体外循环瓣膜置换术心肌损伤。

Objective To investigate the protective effect of Coenzyme Complex on ischemic reperfusion （I/R）induced my- ocardial injury and its possible mechanism in heart valve replacement surgery. Methods Thirty patients with heart valve replacement surgery were randomly divided two groups. A treatment group（n = 15） received Coenzyme Complex in cardio- plegia solution and and in the primary solution before anesthesia, and control group （n= 15） did not received Coenzyme Complex. Blood samples were taken from radial artery the blood to determine the serum concentrations of cTnI, CK-MB, MDA and HCT at various time points during cardiopulmonary bypass（CPB）. Right atrium myocardial biopsy（about 2 mm3） was performed 15 mintues after aortic unclamping for ultrastructure examination with electron microscope. Results After aortic unclamping, the values of cTnI, CK-MB, and MDA in treatment group were significantly lower than those of control group at different time points （P 〈 0.05 or P 〈 0.01 ））;The myocardial microstructures were found less damages in treat- ment group than in control group. Conclusion Coenzyme complex is effective for myocardial protection during heart valve replacement surgery undergoing cardiopulmonary bypass operation.