盐酸戊乙奎醚预处理对体外循环下法洛四联症根治术患儿心肌损伤的影响

Effects of Penehyclidine hydrochloride preconditioning on myocardial injury in pediatric patients undergoing radical correction of tetralogy of Fallot with cardiopulmonary bypass

目的:观察盐酸戊乙奎醚预处理对体外循环(CPB)下法洛四联症根治术患儿心肌损伤的影响。方法:选取择期行CPB下法洛四联症根治术的患儿共100例,采用随机数字表法将患儿分为P组和C组,每组各50例。P组患儿于其颈内静脉穿刺成功后即刻静脉注射盐酸戊乙奎醚0.04 mg/kg;C组患儿于相同时间点静脉注射等容量生理盐水。于麻醉诱导前(T_0)、诱导后10 min(T_1)、复温至36℃(T_2)、CPB停机后1 h(T_3)、术毕(T_4)及术后24 h(T_5)时抽取两组患儿颈内静脉血以检测其血清肿瘤坏死因子-α(TNF-α)、白细胞介素-6和8(IL-6、IL-8)的水平,并进行比较。分别于T_0~T_5时抽取两组患儿的桡动脉血,以测定其血浆心肌肌钙蛋白T(cTnT)浓度。结果:与C组患儿比较,P组患儿T_2~T_5时的血清TNF-α、IL-6、IL-8水平及血浆cTnT浓度均呈显著降低(P<0.05),差异有统计学意义。结论:盐酸戊乙奎醚预处理可减轻CPB下法洛四联症根治术患儿的心肌损伤程度。

Objective： To explore effects of Penehyclidine hydrochloride preconditioning on myocardial injury in pediatric patients undergoing radical correction of tetralogy of Fallot with cardiopulmonary bypass（ CPB）. Methods： One hundred pediatric patients electively undergoing radical correction of tetralogy of Fallot with CPB were selected and divided into P group（ n = 50） and C group（ n = 50） according to the random number table. The P group was injected intravenously with Penehyclidine hydrochloride at a dose of 0. 04 mg/kg,while the C group was given the same volume normal saline at the onset of internal jugular vein puncture success.Thejugular venous blood was extracted to detect the levels of serum tumor necrosis factor-alpha（ TNF-alpha）,interleukin-6 and 8（ IL-6,IL-8） before anesthesia induction（ T0）,10 min after anesthesia induction（ T1）,the onset of re-warming to 36 ℃（ T2）,1h after CPB stopping（ T3）,immediately（ T4） and 24 h after surgery（ T5）,separately,and the radial artery blood was collected to determine the concentration of plasma cardiac troponin T（ cTnT） from T0 to T5. Results： Compared to Cgroup,the levels of serum TNF-α,IL-6,IL-8 and plasma cTnT from T2 to T5 were all lower in P group（ P〈0. 05）. Conclusions： Penehyclidine hydrochloride preconditioning can alleviate myocardial injury in the pediatric patients undergoing radical correction of tetralogy of Fallot with CPB.