CAJ | 학술논문

　　目的本研究在体外循环心肌保护液中应用磷酸肌酸(CP)，观察心内直视手术患者的心肌酶谱的变化，分析其心肌保护作用的效果。方法将100例心脏手术患者分成实验组与对照组，分别观察体外循环前、体外循环后的心肌酶谱（CK、CKMB）的变化趋势，以及患者自动恢复窦性心律或发生心律失常或应用正性肌力药情况。实验组患者在阻断主动脉后，从主动脉根部或冠状动脉灌注含有CP的心肌保护液，对照组应用常规心肌保护液（STH）。结果实验组体外循环前、体外循环后心肌酶谱（CK、CKMB）的变化不显著（P>0.05），而对照组的体外循环前、体外循环后心肌酶谱变化明显（P<0.05）。实验组体外循环结束后自主恢复窦性心律及心律失常发生率和应用正性肌力药维持心功能及血流动力学均好于对照组。结论磷酸肌酸作为心肌的代谢基质确实具有增强心脏停搏液的保护作用，术后血流动力学和心脏电生理指标恢复满意，复苏需用电除颤的比例降低，患者自主恢复窦性心率的比例升高。
　　목적본연구재체외순배심기보호액중응용린산기산(CP)，관찰심내직시수술환자적심기매보적변화，분석기심기보호작용적효과。방법장100례심장수술환자분성실험조여대조조，분별관찰체외순배전、체외순배후적심기매보（CK、CKMB）적변화추세，이급환자자동회복두성심률혹발생심률실상혹응용정성기력약정황。실험조환자재조단주동맥후，종주동맥근부혹관상동맥관주함유CP적심기보호액，대조조응용상규심기보호액（STH）。결과실험조체외순배전、체외순배후심기매보（CK、CKMB）적변화불현저（P>0.05），이대조조적체외순배전、체외순배후심기매보변화명현（P<0.05）。실험조체외순배결속후자주회복두성심률급심률실상발생솔화응용정성기력약유지심공능급혈류동역학균호우대조조。결론린산기산작위심기적대사기질학실구유증강심장정박액적보호작용，술후혈류동역학화심장전생리지표회복만의，복소수용전제전적비례강저，환자자주회복두성심솔적비례승고。
Objective The purpose of this project is the observation of change of myocardial enzymes of surgical patients under direct vision of cardiology, creatine kinase is added, in order to judge the effectiveness of its myocardial cytoprotective effects. Methods 100 cases patients who need surgery were divided into experimental and control groups to respectively observe the changes of myocardial enzymes, spontaneous restoration of sinus rhythm, arrhythmia, positive inotropic drugs situation before and after cardiopulmonary bypass. The patients of experimental group were perfused by protective liquid of Myocardial cells containing CP (10mmol/L CP was joined in STH). Conventional cardioplegia was used in the control group. Result The changes of cardiac enzymes is not signiifcant (P>0.05) in the experimental group before and after cardiopulmonary bypass. The changes of cardiac enzymes is signiifcant (P<0.05) in the control group before and after cardiopulmonary bypass. The role in the effectiveness of spontaneous return to sinus rhythm, arrhythmia, and application myocardial inotropic drugs of the experimental group were better than them of the control group. Conclusion Creatine kinase signiifcantly enhanced the protective effect of cardioplegic solution. It contributes to recovery of indicators of electrophysiological and hemodynamic. At the same time it can reduce the proportion of deifbrillation, however signiifcantly, it can raise the proportion of spontaneous restoration of sinus rhythm.