多西环素对心肺转流后心肌缺血-再灌注损伤的保护作用

Protective effect of doxycycline on myocardial ischemia-reperfusion injury after cardiopulmonary bypass

目的探讨基质金属蛋白酶2(MMP-2)抑制剂多西环素对心肺转流(CPB)后心肌缺血-再灌注损伤的保护作用。方法成人风湿性心脏瓣膜病患者38例,随机分成两组:治疗组,18例,术前1周每日口服多西环素100mg;对照组,20例,术前不用多西环素。于术晨(T1)、术后返ICU即刻(T2)、术后3h(T3)、术后12h(T4)4个时点测定两组血浆MMP-2、肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)含量。结果与术前比较,两组MMP-2、cTnI及CK-MB浓度术后均明显升高;对照组T2、T3时MMP-2、cTnI及CK-MB高于治疗组(P<0.05)。结论多西环素可以减轻CPB后心肌缺血-再灌注损伤。

Objective To investigate the protective effect of doxycycline（a matrix metalloproteinases-2 inhibitor） on myocardial ischemia-reperfusion injury after cardiopulmonary bypass（CPB）.Methods Thirty-eight adult patients with rheumatic heart valve diseases were randomly divided into two groups of T（18 cases,treated with doxycycline 100 mg/d for 7 days before operation） and C（20 cases,treated with placebo）.Plasma concentrations of MMP-2,troponin I（cTnI） and creatine kinase-MB（CK-MB） were measured by ELISA at 4 time points of T1（before surgery）,T2（at the time back to ICU after surgery）,T3（at 3 hours after surgery） and T4（at 12 hours after surgery）.Results Compared to before,plasma concentrations of MMP-2,cTnI and CK-MB after CPB were increased remarkably in both groups.Plasma concentrations of MMP-2,cTnI and CK-MB at T2 and T3 in group C were higher than those in group T（P0.05）.Conclusion Doxycycline can attenuate myocardial ischemia-reperfusion injury after CPB.