CAJ | 학술논문

目的：探讨分析依达拉奉预防不停跳冠状动脉搭桥术后心肌缺血的可行性。方法78例不停跳冠状动脉搭桥术的患者随机分为治疗组和对照组，各39例。在麻醉诱导后，治疗组持续静脉滴注依达拉奉60mg，对照组持续静脉滴注等量生理盐水，对比分析患者术前（T1）、切皮后1h（T2），术毕（T3），和术后24h（T4）的血清超氧化物歧化酶（SOD）、丙二醛（MDA）水平，以及T1、T4的血浆脑钠肽（BNP）、肌钙蛋白I（cTnI）含量，对比患者术前、术后的左心射血分数（LVEF）。结果两组患者间用药前SOD、MDA、肌酸激酶同工酶（CK-MB）、BNP和cTnI差异无统计学意义（P＞0．05），T2、T3、T4点治疗组SOD活性显著高于对照组（P＜0．05），治疗组MDA值、CK-MB值显著低于对照组（P＜0．05）；T4点治疗组BNP及cTnI值低于对照组（P＜0．05），LVEF％明显高于对照组（P＜0．05）。治疗组患者术后呼吸机治疗时间、重症病房住院时间及总住院时间明显小于对照组（P＜0．05）。结论依达拉奉能够有效清除不停跳冠状动脉搭桥术患者体内氧自由基，减少心肌酶的释放，减少心肌缺血再灌注带来的损伤，起到保护心肌细胞的作用。
목적：탐토분석의체랍봉예방불정도관상동맥탑교술후심기결혈적가행성。방법78례불정도관상동맥탑교술적환자수궤분위치료조화대조조，각39례。재마취유도후，치료조지속정맥적주의체랍봉60mg，대조조지속정맥적주등량생리염수，대비분석환자술전（T1）、절피후1h（T2），술필（T3），화술후24h（T4）적혈청초양화물기화매（SOD）、병이철（MDA）수평，이급T1、T4적혈장뇌납태（BNP）、기개단백I（cTnI）함량，대비환자술전、술후적좌심사혈분수（LVEF）。결과량조환자간용약전SOD、MDA、기산격매동공매（CK-MB）、BNP화cTnI차이무통계학의의（P＞0．05），T2、T3、T4점치료조SOD활성현저고우대조조（P＜0．05），치료조MDA치、CK-MB치현저저우대조조（P＜0．05）；T4점치료조BNP급cTnI치저우대조조（P＜0．05），LVEF％명현고우대조조（P＜0．05）。치료조환자술후호흡궤치료시간、중증병방주원시간급총주원시간명현소우대조조（P＜0．05）。결론의체랍봉능구유효청제불정도관상동맥탑교술환자체내양자유기，감소심기매적석방，감소심기결혈재관주대래적손상，기도보호심기세포적작용。
Objective To explore and analysis feasibility of the prevention of edaravone on myocardial ischemia after beating cor-onary artery bypass grafting .Methods From June 2011 to December 2012 ,78 patients which accepted beating heart coronary artery bypass grafting were randomly divided into treatment group (39 cases) and control group(39 cases) .After induction of anesthesia , the treatment group were continued to intravenous edaravone 60 mg ,while the control group were continued infusion of equivalent saline .The serum superoxide dismutase(SOD) ,malondialdehyde(MDA) levels were compared between the two groups at different times which were before surgery (T1) ,after incision 1 h(T2) ,surgery (T3) ,and after 24 h(T4) ,plasma brain natriuretic peptide (BNP) ,troponin I(cTnI) levels were compared at T1 and T4 .Left ventricular ejection fraction(LVEF) were also be compared .Re-sults The two groups of patients before treatment ,there were not statistically significant difference between the two groups on SOD ,MDA ,CK-MB ,BNP and cTnI(P> 0 .05) .At T2 ,T3 ,T4 point ,the SOD activity of the treatment group was significantly higher than that of control group(P<0 .05) .The MDA ,CK-MB value were significantly lower than that of control group (P<0 . 05) .At T4 ,the BNP and cTnI in the treatment group were less than that of control group (P<0 .05) .The postoperative LVEF% in treatment group were significantly higher than that of control group (P<0 .05) .Postoperative ventilator treatment time and ICU stay time and total hospitalization time of the treatment group were all significantly less than that of control group (P<0 .05) .Con-clusion For the beating heart coronary artery bypass surgery patients ,edaravone can effectively scavenge oxygen free radicals and reduce the release of enzymes ,reduce injury caused by myocardial ischemia-reperfusion and protect myocardial cells .