【摘要】 目的评价环磷腺苷葡胺(MAC)预处理对冠状动脉旁路移植术患者的心肌保护作用。方法选取2013年12月至2015年6月邢台市第三医院心外科择期行冠状动脉旁路移植术的患者按随机数表法随机分为对照组(n=46)和MAC预处理组(n=50)。在麻醉诱导成功后从颈内静脉以0.02 mg/(kg·min)输注1次环磷腺苷葡胺(1.0 mg/kg),而对照组则仅给予等量生理盐水。分别于术后30 min、6 h、12 h、24 h、48 h、72 h采静脉血,即刻检测两组患者的磷酸肌酸激酶同工酶(CK-MB)和心肌钙蛋白(c TNI)水平。结果所有患者均成功接受冠状动脉旁路移植术。(1)CK-MB:对照组与预处理组术后6 h[(32.62±9.70)vs(26.45±7.84)]和24 h[(25.80±10.41)vs(21.13±6.70)]比较,差异均有统计意义(P<0.05);(2)c TNI:对照组与预处理组术后6 h[(32.62±9.70)vs(26.45±7.84)]、24 h[(25.80±10.41)vs(21.13±6.70)]、48 h[(19.03±7.91)vs(16.32±6.88)和72 h[(15.91±6.52)vs(14.64±4.06)]比较,差异均有统计意义(P<0.05)。结论在冠状动脉旁路移植术中,环磷酰苷葡胺预处理可以减轻心肌损伤。更多还原

【Abstract】 Objective To evaluate the myocardial protective effect of meglumine adenosine cyclophosphate(MAC) pretreatment on patients undergoing coronary artery bypass grafting surgery. Methods A total of 96 adult patients, who underwent coronary artery bypass grafting surgery in Department of Cardiac Surgery of Xingtai Third Hospital from December 2013 to June 2015, were randomized to MAC group(n=50) and control group(n=46). After induction of anesthesia, the internal jugular vein infusion of 0.02 mg/(kg· min) MAC for one time was performed(1.0 mg/kg),while the control group only received physiological saline. Venous blood samples were collected 30 minutes, 6 h, 24 h,48 h, 72 h after surgery, and creatine kinase-MB(CK-MB), cardiac troponin-I(c Tn I) of myocardial enzymes were measured. Results Coronary artery bypass graft surgery was performed successfully in all patients.(1) CK-MB: Compared with the control group, CK-MB of the pretreatment group was significantly lower 6 h [(32.62±9.70) vs(26.45±7.84), P<0.05] and 24 h [(25.80±10.41) vs(21.13±6.70), P<0.05] after surgery.(2) c Tn I: Compared with the control group, c Tn I of the pretreatment group was significantly lower 6 h [(32.62 ± 9.70) vs(26.45 ± 7.84), P<0.05], 24 h [(25.80 ± 10.41) vs(21.13±6.70), P<0.05], 48 h [(19.03±7.91) vs(16.32±6.88), P<0.05], 72 h [(15.91±6.52) vs(14.64±4.06), P<0.05] after surgery. Conclusion MAC pretreatment on patients undergoing coronary artery bypass grafting surgery can relieve myocardial injury.更多还原