参芪扶正注射液对心瓣膜替换术的心肌保护

The effect of myocardial protection on shenqi fuzheng injection at heart valve replacement patients

目的研究风湿性心脏病心瓣膜替换术患者围术期应用参芪扶正注射液对心肌的保护作用。方法 32例风湿性心脏病体外循环下心瓣膜替换术患者随机分为治疗组和对照组 ,每组 16例。治疗组患者手术前、后 3天每天静脉滴注参芪扶正注射液 5 0 0ml,手术时预充液中一次性加入5 0 0ml;对照组除不用参芪扶正注射液外 ,其它条件与治疗组相同。结果治疗组患者术毕和术后多巴胺、多巴酚丁胺等血管活性药物用量明显少于对照组 (P <0 0 5或P <0 0 1) ;血清心肌肌钙蛋白T(cTnT)、门冬氨基酸转移酶 (AST)、乳酸脱氢酶 (LDH)、肌酸激酶 (CK)、肌酸激酶MB同工酶 (CK MB)从转流毕到术后 1天明显低于对照组 (P <0 0 5或P <0 0 1) ;治疗组患者术毕心脏自动复跳率明显高于对照组 (P <0 0 5 ) ;两组患者于手术前 1天心脏彩超显示二者的心脏指数 (CI)、左心射血分数 (EF)差异无显著性 (P >0 0 5 ) ,术后 7天 ,治疗组CI、EF明显高于对照组 (P <0 0 5或P <0 0 1)。治疗组心肌超微结构显示 :治疗组患者心内操作完毕后心肌细胞水肿轻 ,肌纤维完整 ,而对照组则相反。结论参芪扶正注射液对风湿性心脏病心瓣膜替换术患者有较好的心肌保护作用 ,临床应用值得推广。

Objective To investgigate the effects of myocardial protection of shenqi fuzheng injection on heart valve replacement patients. Methods 32 cases of heart valve replacement patients with cardiopulmonary bypass (CPB) were divided into test group and control group. The test group patients were administrated with shenqi fuzheng injection of 500ml for intravenous drip before and after 3 days operation, and 500ml were administrated in operation. Results The changes of the myocardial enzyme spectrum, troponin I, etc. Were significantly decrease than those in control group on different times ( P <0.05, or P <0.01). Conclusion Shenqi fuzheng injection is an advantageous conditions to myocardial protection for heart valve replacement patients with cardiopulmonary bypass.