【作者】 邓云坤； 韦方； 张大国； 安邦权； 刘秀伦； 许进福；

【Author】 Deng yunkun,Wei fang,Zhang daguo,et al.Department of Anesthesiology,Guizhou Provincial People’s Hospital,Guiyang(550002),China.

【机构】 贵州省人民医院；

【摘要】 目的探讨银杏叶提取物金纳多对低温体外循环（CPB）红细胞的保护效果。方法择期行风湿性心脏病二尖瓣置换术患者60例,ASAⅡⅢ级,全凭静脉麻醉后,按随机数字表法随机分为两组（n=30）,银杏组:开胸之前给予银杏叶提取物（金纳多^）1mg/kg,静脉滴注,CPB开始前滴完;对照组:以等量生理盐水同速度静脉滴注。分别在CPB开始前（T₁）、鼻咽温（降至30℃31℃）稳定期（T₂）、鼻咽温复温至36℃（T₃）、CPB结束后30min（T₄）、CPB结束后3h（T₅）五个时点同步采集桡动脉,测定血浆丙二醛（P-MDA）、红细胞丙二醛（E-MDA）、红细胞超氧化物歧化酶（E-SOD）、Na⁺-K⁺-ATP酶、Ca⁺-Mg²⁺-ATP酶活性。结果与T₁比较,对照组T_2-5时P-MDA、E-MDA水平升高,T₂时E-SOD升高,T_3-5时E-SOD浓度降低（P<0.01）,银杏组T_3,4时P-MDA、E-MDA水平升高（P<0.05或P<0.01）;与对照组比较,银杏组T_2-5时P-MDA、E-MDA水平较低,T_3-5时E-SOD活性较高（P<0.05或P<0.01）。与T₁比较,两组T₂时Na⁺-K⁺-ATP酶、Ca⁺-Mg²⁺-ATP酶活性升高,对照组T_3-5时这两种酶活性降低（P<0.05或P<0.01）;银杏组T_2-5时这两种酶活性高于对照组同期（P<0.05或P<0.01）。结论低温CPB期间银杏叶提取物金纳多通过减轻红细胞膜脂质过氧化反应,发挥红细胞保护作用。更多还原

【Abstract】 Objective To investigate the erythrocyte protective effects of Ginkgo biloba extract Ginaton in patients who underwent hypothermic cardiopulmonary bypass（CPB）.Methods Sixty patients with rheumatic heart disease of ASA gradeⅡ～Ⅲ,who were scheduled for mitral valve replacement with intravenous anesthesia,were randomly divided assigned to two groups,the Ginaton group（30 patients） treated with Ginaton 1mg/kg by intravenous dripping before open heart for CPB,and the control group（30 patients） with normal saline instead.Blood samples were taken from radial artery before CPB（T₁）,nasopharyngeal temperature（lowered to 30-31℃） stabilized stage（T₂）, nasopharyngeal temperature restoration（36℃）stage（T₃）,30 min after CPB（T₄） and 3 h after CPB（T₅）,for determination of plasma and erythrocyte MDA（P-MDA,E-MDA） levels and erythrocyte SOD（E-SOD）,Na⁺-K⁺-ATPase and Ca⁺-Mg²⁺-ATPase activities.Results The levels of P-MDA and E-MDA were significantly increased at T_2-5 in control group but only at T₃ and T₄ in Ginaton group compared to the baseline at T₁（P<0.05 or 0.01）.The levels of P-MDA and E-MDA at T_2-5 were significantly higher in control group than in Ginaton group（P<0.05 or 0.01）.The E-SOD,Na⁺-K⁺-ATPase and Ca⁺-Mg²⁺-ATPase activities significantly increased at T₂ compared to baseline at T₁,then gradually decreased in both groups（P<0.05 or 0.01）.They were significantly higher at T_3-5 in Ginaton group than in control group（P<0.05 or 0.01）.Conclusion Ginkto biloba extract,Ginaton can alleviate erythrocyte lipid peroxidation and protect erythrocyte during CPB.更多还原