盐酸戊乙奎醚对非体外循环冠状动脉搭桥术患者微循环及心肌损伤的影响

Effect of penehyclidine hydrochloride on microcirculation and myocardial injury in patients underwent off-pump coronary artery bypass grafting

目的探讨盐酸戊乙奎醚对非体外循环冠状动脉搭桥术(OPCABG)患者微循环及心肌损伤的影响。方法选择2015年10月至2016年12月择期于郑州大学第二附属医院全身麻醉下行OPCABG的患者40例,随机分为盐酸戊乙奎醚组和对照组,每组20例。盐酸戊乙奎醚组患者于右侧颈内静脉穿刺置管术后注入盐酸戊乙奎醚0.05 mg·kg^(-1),对照组患者予以等容量生理盐水,分别于麻醉诱导后(T_0)、注入盐酸戊乙奎醚后血管吻合完成即刻(T_1)、术后2 h(T_2)、术后24 h(T_3)时采集动脉血检测乳酸(LA)水平,采集中心静脉血检测静脉血氧饱和度(SvO_2)及心肌肌钙蛋白I(cTnI)水平,并记录相应时间点的尿量。结果 T_0时2组患者血清LA、cTnI水平及SvO_2、尿量比较差异均无统计学意义(P>0.05)。对照组患者T_1、T_2、T_3时血清LA、cTnI水平及尿量显著高于T_0时(P<0.05),SvO_2显著低于T_0时(P<0.05)。盐酸戊乙奎醚组患者T_1、T_2、T_3时血清LA、cTnI水平及尿量显著高于T_0时(P<0.05),T_2、T_3时SvO_2显著高于T_0时(P<0.05)。T_1、T_2、T_3时盐酸戊乙奎醚组患者血清LA、cTnI水平显著低于对照组(P<0.05),SvO_2、尿量显著高于对照组(P<0.05)。结论盐酸戊乙奎醚具有改善OPCABG患者微循环、保护心肌的作用。

Objective To investigate the effect of penehyclidine hydrochloride on microcirculation and myocardial injury in patients underwent off-pump coronary artery bypass grafting （OPCABG）.Methods Forty patients underwent OPCABG under general anesthesia were selected from October 2015 to December 2016 in the Second Affiliated Hospital of Zhengzhou University.The patients were randomly divided into penehyclidine hydrochloride group and control group,20 cases in each group.The patients in the penehyclidine hydrochloride group were injected with penehyclidine hydrochloride 0.05 mg ＆#183; kg-1 after right internal jugular vein puncture,and the patients in the control group were given equal capacity saline.The level of lactic acid （LA） in the arterial blood,the venous oxygen saturation （SvO2） and cardiac troponin I （cTnI） level in the central venous blood were detected,and the urine volume was recorded at the time points of after the anesthesia induction （T0）,the vascular anastomosis completion after the injection of penehyclidine hydrochloride（T1）,two hours （T2） and 24 hours （T3） after operation.Results There was no significant difference in serum LA and cTnI levels,SvO2,urine volume between the two groups at T0 （P 〉 0.05）.The serum LA and cTnI levels and urine volume at T1,T2 and T3 were significantly higher than those at T0（P 〈0.05）,and the SvO2 at T1,T2 and T3 was significantly lower than that at T0 in the control group（P 〈0.05）.The serum LA and cTnI levels and urine volume at T1,T2 and T3 were significantly higher than those at T0 （P 〈 0.05）,and the SvO2 at T2 and T3 was significantly higher than that at T0 in the penehyclidine hydrochloride group （P 〈 0.05）.The serum LA and cTnI levels in the penehyclidine hydrochloride group were significantly lower than those in the control group at T1,T2 and T3 （P 〈 0.05）,the SvO2 and urine volume in the penehyclidine hydrochloride group were significantly higher than those in the control group at T1,T2 and T3 （P 〈 0.05）.Conclusion Penehyclidine hydrochloride can improve microcirculation and protect myocardium in patients underwent OPCABG.