依达拉奉预防不停跳冠状动脉搭桥术后心肌缺血可行性分析

Feasibility analysis on the prevention of edaravone on myocardial ischemia after beating coronary artery bypass grafting

目的探讨分析依达拉奉预防不停跳冠状动脉搭桥术后心肌缺血的可行性。方法 78例不停跳冠状动脉搭桥术的患者随机分为治疗组和对照组,各39例。在麻醉诱导后,治疗组持续静脉滴注依达拉奉60mg,对照组持续静脉滴注等量生理盐水,对比分析患者术前(T1)、切皮后1h(T2),术毕(T3),和术后24h(T4)的血清超氧化物歧化酶(SOD)、丙二醛(MDA)水平,以及T1、T4的血浆脑钠肽(BNP)、肌钙蛋白I(cTnI)含量,对比患者术前、术后的左心射血分数(LVEF)。结果两组患者间用药前SOD、MDA、肌酸激酶同工酶(CK-MB)、BNP和cTnI差异无统计学意义(P>0.05),T2、T3、T4点治疗组SOD活性显著高于对照组(P<0.05),治疗组MDA值、CK-MB值显著低于对照组(P<0.05);T4点治疗组BNP及cTnI值低于对照组(P<0.05),LVEF%明显高于对照组(P<0.05)。治疗组患者术后呼吸机治疗时间、重症病房住院时间及总住院时间明显小于对照组(P<0.05)。结论依达拉奉能够有效清除不停跳冠状动脉搭桥术患者体内氧自由基,减少心肌酶的释放,减少心肌缺血再灌注带来的损伤,起到保护心肌细胞的作用。

Objective To explore and analysis feasibility of the prevention of edaravone on myocardial ischemia after beating cor-onary artery bypass grafting .Methods From June 2011 to December 2012 ,78 patients which accepted beating heart coronary artery bypass grafting were randomly divided into treatment group （39 cases） and control group（39 cases） .After induction of anesthesia , the treatment group were continued to intravenous edaravone 60 mg ,while the control group were continued infusion of equivalent saline .The serum superoxide dismutase（SOD） ,malondialdehyde（MDA） levels were compared between the two groups at different times which were before surgery （T1） ,after incision 1 h（T2） ,surgery （T3） ,and after 24 h（T4） ,plasma brain natriuretic peptide （BNP） ,troponin I（cTnI） levels were compared at T1 and T4 .Left ventricular ejection fraction（LVEF） were also be compared .Re-sults The two groups of patients before treatment ,there were not statistically significant difference between the two groups on SOD ,MDA ,CK-MB ,BNP and cTnI（P〉 0 .05） .At T2 ,T3 ,T4 point ,the SOD activity of the treatment group was significantly higher than that of control group（P〈0 .05） .The MDA ,CK-MB value were significantly lower than that of control group （P〈0 . 05） .At T4 ,the BNP and cTnI in the treatment group were less than that of control group （P〈0 .05） .The postoperative LVEF% in treatment group were significantly higher than that of control group （P〈0 .05） .Postoperative ventilator treatment time and ICU stay time and total hospitalization time of the treatment group were all significantly less than that of control group （P〈0 .05） .Con-clusion For the beating heart coronary artery bypass surgery patients ,edaravone can effectively scavenge oxygen free radicals and reduce the release of enzymes ,reduce injury caused by myocardial ischemia-reperfusion and protect myocardial cells .