左西孟旦对体外循环冠状动脉旁路移植术后心功能不全的疗效

Effects of levosimendan on cardioplegia after cardiopulmonary bypass coronary artery bypass grafting

目的探讨左西孟旦(LEV)对体外循环冠状动脉旁路移植术(CABG)后心功能不全的疗效。方法将96例行CABG患者分为试验组和对照组,对行CABG术后两组患者均给予常规治疗,试验组患者加用12.5mg LEV静脉滴注。比较两组患者术后24、48、72h心肌损伤指标,以及12、24h时心功能参数。结果试验组患者术后48、72h心肌损伤指标肌钙蛋白(cTnI)、乳酸脱氢酶(LDH)和磷酸肌酸激酶同工酶(CKMB)水平均显著低于对照组(P<0.05)。术后12、24h试验组心功能指标与对照组比较,中心静脉压(CVP)低于对照组,心输出量(CO)和体循环阻力(SVR)高于对照组,组间差异有统计学意义(P<0.05)。结论 LEV可有效降低CABG术后患者的心肌损伤,增大CO,降低SVR,保护心功能,促进术后心脏功能恢复。

Objective To investigate the effect of levosimendan(LEV)on cardiopulmonary insufficiency after cardiopulmonary bypass coronary artery bypass grafting(CABG).Methods A total of 96 patients with CABG were randomly divided into experimental group and control group.All patients were treated with conventional therapy after surgery while patients in experimental group were given intravenous infusion of 12.5 mg LEV.The myocardial injury parameters at 24,48 and 72 h after operation were compared,meanwhile the cardiac function parameters at 12 and 24 h were evaluated between both groups.Results The levels of troponin(cTnI),lactate dehydrogenase(LDH)and creatine phosphokinase isoenzyme(CK-MB)were significantly lower in the experimental group than those in the control group at 48 and 72 h after operation(P<0.05).Compared with the control group,the central venous pressure(CVP)of the experimental group was lower than that of the control group at 12 and 24 h after operation.The cardiac output(CO)and systemic circulation resistance(SVR)were higher than those in the control group(P<0.05).Conclusion LEV effectively reduced myocardial injury on patients with CABG,in the meantime it increased cardiac output,reduced systemic resistance,thus effectively protecting heart function,promoting postoperative cardiac function recovery.