磷酸肌酸对心脏瓣膜置换术患者心肌保护效果评价

Protective effect of phosphocreatine on myocardial in patients with heart valve replacement surgery

目的初步评价磷酸肌酸对心脏瓣膜置换术患者心肌的保护作用。方法选择心脏瓣膜置换术患者60例,分为对照组和磷酸肌酸预处理组,对照组使用St.Thomas心脏停搏液,磷酸肌酸预处理组于St.Thomas心脏停搏液中加入磷酸肌酸(10 mmo1/L),测定血浆心肌肌钙蛋白、肌酸激酶及肌酸激酶同工酶含量。结果磷酸肌酸预处理组和对照组比较,体外循环停转流后2 h,心肌肌钙蛋白含量和肌酸激酶含量均明显下降(均P<0.05);体外循环停转流后12 h,心肌肌钙蛋白含量、肌酸激酶含量和肌酸激酶同工酶含量均明显下降(均P<0.05)。结论磷酸肌酸对体外循环下行心脏瓣膜置换术患者具有明显的心肌保护作用。

Objective To evaluate protective effect of phosphocreatine on myocardial in patients with heart valve re- placement surgery. Methods Sixty patients undergoing heart valve replacement surgery were selected and divided ran- domly into two groups（30 patients in each group）. The patients in control group were given St. Thomas cardioplegic so- lution and those in phosphocreatine-treated group received St. Thomas cardioplegic solution plus phosphocreatine （10 retool/L）. The levels of cardiac troponin-I（cTnI） ,craetine kinase（CK） ,and creatine kinase-MB fraction （ck-MB） were measured. Results The serum levels of cTnI and CK were significantly lower in phosphocreatine-treated group than those in the control group 2 hours after the cardiopulmonary bypass operation（ all P 〈 0. 05 ）, and the levels of cTnI, CK and CK-MB were significantly lower in phosphocreatine-treated group than those in the control group 12 hours after cardiopulmonary bypass operation （ all P 〈 0. 05）. Conclusion Phosphoereatine has significant protective effect on myo- cardial in patients with heart valve replacement surgery.