ACE抑制剂在CPB围术期心肌保护中的机制研究

The Mechanism of ACE Inhibitor in the Protection of Myocardial during CPB

目的:通过观察心肌标志物的变化,探究ACE抑制剂在CPB围术期心肌保护中的机制。方法:选取本院从2015年1-10月所接诊的72例风湿性的二尖瓣狭窄患者,根据多态性的ACE基因将患者分为II、ID和DD三组,每组各24例,在不同的时刻点抽取三组的外周静脉血,对其ACE及心肌标志物的含量变化进行检测与对比。结果:ACE及心肌标志物在CPB后及CPB中的含量均高于CPB前的,DD型血清中ACE及心肌标志物的含量都比ID型及II型的高,差异均有统计学意义(P<0.05)。结论:ACE抑制剂可以降低在CPB围手术时心肌的长时间缺血后进行的再灌注的心肌细跑损伤,提高了手术的安全性,值得推广和应用。

Objective：To investigate the relationship between ACE gene polymorphism and myocardial protection during perioperative period of CPB through observe the change of myocardial markers.Method：72 patients who suffered from rheumatic mitral stenosis in our hospital were selected from January to October 2015. According to the genotype of ACE they were divided into three groups：type Ⅱ group,type ID group and type DD group,24 cases in each group.The peripheral venous blood of three groups were selected at different moments, the ACE and the content changes of myocardial markers were detected and compared.Result：The level of ACE during CPB and after CPB were higher then those before CPB,the level of ACE with DD genotype was significantly higher than the ID and Ⅱ genotype, the differences were statistically significant（P0.05）. Conclusion：ACE inhibitors reduce myocardial cells injury at CPB perioperative after myocardial cells live myocardial longer ischaemia and then reperfusion, improve the safety of surgery,it is worthy of promotion and application.