复心煎对临床心肌缺血再灌注损伤的保护作用

The protective effect of FuXinJian pretreatment on clinical myocardial ischemia reperfusion injury

目的：探讨复心煎预处理对临床心脏瓣膜置换患者术中心肌缺血再灌注损伤的保护作用。方法：选取符合研究条件的心脏瓣膜病患者60例，随机分为两组（n=30）：对照组和观察组，术前对照组常规治疗，观察组常规治疗外服用复心煎10~12天，在麻醉前（T1）、心肌再灌注30min （T2）、1h （T3）、2h （T4）、3h （T5）共5个时间点取桡动脉血及静脉血，分别检测动脉血血浆中超氧化物歧化酶（SOD）、丙二醛（MDA ）、磷酸肌酸激酶同工酶（CK-MB ）及肌钙蛋白I （cTnI）水平，静脉血检测血常规、白介素8（IL-8）浓度，并记录心肌再灌注3h内心电图变化，再灌注3h后行心脏彩超检查。结果：心肌再灌注后观察组中性粒细胞数、CK-MB、cTnI、IL-8及MDA水平均显著低于对照组（P〈0.05），SOD水平则明显高于对照组（P〈0.05），并且室性心律失常、心室收缩功能减退例数明显少于对照组。结论：复心煎预处理降低了临床心肌缺血再灌注损伤的程度，起到了保护心肌功能的作用。

Objective：To investigate the protective effect of the FuXinJian pretreatment on intraoperative myocardial ischemia-reperfusion injury of clinical heart valve replacement patients. Methods：60 patients with valvular heart disease eligible for the study were randomly divided into two groups （n = 30）： the control group and the experimental group. The control group got routine preoperative therapy, and the experimental group took the FuXinJian 10 to 12 days besides con-ventional treatment. Blood samples from the radial artery and vena were collected before anesthesia （T1）, at myocardial reperfusion 30min （T2）, 1h （T3）, 2h （T4） and 3h （T5）. Arterial blood were detected for superoxide dismutase （SOD）, malon-dialdehyde （MDA）, creatine kinase isoenzyme （CK-MB） and cardiac troponin I （cTnI） levels, and venous blood were used to examine the complete blood count, and the interleukin- 8 （IL-8） concentration. Furthermore, we recorded ECG changes were recorded and did echocardiography examination was conducted 3th within and when 3h after reperfusion. Results：The number of neutrophil, CK-MB, cTnI, IL-8 and MDA levels of the experimental group were lower, but SOD levels were higher than the control group significantly （P〈0.05） after reperfusion. In addition, the number of cases with both ventricular arrhythmias and ventricular systolic dysfunction, was significantly smaller than the control group. Conclusion：The FuXin-Jian pretreatment reduced the clinical myocardial ischemia reperfusion injury, which played a role in the protection of my-ocardial function.