乌司他丁预处理对心脏瓣膜置换患者心肌氧化应激损伤的保护作用

Protective effects of ulinastatin preconditioning on myocardial oxidative stress injury in patients undergoing cardiac valve replacement

目的研究乌司他丁预处理对心脏瓣膜置换患者心肌氧化应激损伤的保护作用。方法将2012年5月至2014年5月在我院接受心脏瓣膜置换手术的70例患者纳入研究,根据麻醉诱导时的处理方法不同随机分为两组,观察组在麻醉诱导后接受乌司他丁预处理,对照组接受常规麻醉诱导,检测两组患者的心肌酶谱指标、氧化损伤指标以及炎症因子。结果 (1)心肌酶谱:观察组患者的血浆肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(c Tn T)含量低于对照组;(2)氧化损伤指标:观察组血浆脂质过氧化物(LPO)含量低于对照组,还原型谷胱甘肽(GSH)、超氧化物歧化酶(SOD)含量高于对照组;(3)炎症因子:观察组患者的血浆TNF-α、IL-6含量低于对照组,IL-10含量高于对照组。结论乌司他丁预处理有助于减少心肌细胞损伤、缓解氧化反应和炎症反应,是心脏瓣膜置换术麻醉诱导时理想的处理方法。

Objective To study the protective effects of ulinastatin preconditioning on myocardial oxidative stress injury in patients undergoing cardiac valve replacement. Methods 70 cases patients received cardiac valve replacement in our hospital from May 2012 to May 2014 were enrolled and randomly divided into two groups according to different processing method during anesthesia induction. Observation group received ulinastatin treatment after anesthesia induction, control group received routine anesthesia induction. Then myocardial enzymes spectrum index, oxidative damage and inflammatory factor were detected. Results(1) Myocardial enzyme spectrum: plasma CK-MB, c Tn T content of observation group were lower than those of control group;(2) Oxidative damage index: plasma MDA content of observation group were lower than that of control group; GSH, SOD contents of observation group were lower than those of control group;(3) Inflammatory factor: plasma TNF-α, IL-6 content of observation group were lower than those of control group; IL-10 content was higher than that of control group. Conclusions Ulinastatin treatment is helpful to reduce myocardial cell damage, relieve oxidation reaction and inflammatory reaction; it’s an ideal treatment method during anesthesia induction in cardiac valve replacement surgery.