CAJ | 학술논문

目的评价依达拉奉对非体外循环冠脉搭桥术患者心肌的保护作用.方法择期非体外循环下冠脉搭桥术患者40例,ASA分级Ⅲ或Ⅳ级,NYHA心功能Ⅱ或Ⅲ级,年龄45～64岁,体重55～95 kg,性别不限.采用随机数字表法,分为试验组(E组,n=20)和对照组(C组,n=20).在麻醉诱导后,E组静脉输注依达拉奉60 mg,给药时间30 min,C组给予等容量生理盐水.于术前(T1)、切皮后1 h(T2)、术毕(T3)和术后24 h(T4)分别取静脉血标本,测定血清心肌酶及肌钙蛋白Ⅰ(cTnI)水平.记录患者术后呼吸机治疗时间、ICU停留时间及住院时间.结果与C组比较,E组血清肌酸激酶、肌酸激酶同工酶及乳酸脱氢酶的活性和cTnI浓度,T1时差异无统计学意义(P＞0.05)；T3,4时均明显升高(P＜0.05)；与T1时比较,T3,4时两组以上指标均明显升高(P＜0.05).术后呼吸机治疗时间、ICU停留时间及住院时间E组较C组明显缩短(P＜ 0.05或0.01).结论非体外循环下冠脉搭桥术开始前静脉输注依达拉奉60 mg,可产生有效的心肌保护作用.
목적 평개의체랍봉대비체외순배관맥탑교술환자심기적보호작용.방법 택기비체외순배하관맥탑교술환자40례,ASA분급Ⅲ혹Ⅳ급,NYHA심공능Ⅱ혹Ⅲ급,년령45～64세,체중55～95 kg,성별불한.채용수궤수자표법,분위시험조(E조,n=20)화대조조(C조,n=20).재마취유도후,E조정맥수주의체랍봉60 mg,급약시간30 min,C조급여등용량생리염수.우술전(T1)、절피후1 h(T2)、술필(T3)화술후24 h(T4)분별취정맥혈표본,측정혈청심기매급기개단백Ⅰ(cTnI)수평.기록환자술후호흡궤치료시간、ICU정류시간급주원시간.결과 여C조비교,E조혈청기산격매、기산격매동공매급유산탈경매적활성화cTnI농도,T1시차이무통계학의의(P＞0.05)；T3,4시균명현승고(P＜0.05)；여T1시비교,T3,4시량조이상지표균명현승고(P＜0.05).술후호흡궤치료시간、ICU정류시간급주원시간E조교C조명현축단(P＜ 0.05혹0.01).결론 비체외순배하관맥탑교술개시전정맥수주의체랍봉60 mg,가산생유효적심기보호작용.
Objective To evaluate the effect of edaravone on myocardial injury in patients undergoing offpump coronary artery bypass grafting (OPCABG).Methods Forty ASA physical status Ⅲ-Ⅳ patients,aged 45-64 yr,weighing 55-95 kg,with NYHA class Ⅱ-Ⅲ,scheduled for elective OPCABG,were randomly divided into 2 groups (n =20):edaravone group (group E) and control group (group C).After induction of anesthesia,edaravone 60 mg (in 100 ml of normal saline) was infused over 30 min in group E,while the equal volume of normal saline was given instead of edaravone in group C.Venous blood samples were taken before operation (T1),after skin incision (T2),at the end of operation (T3),and at 24 h after operation (T4) to measure the serum levels of myocardial enzymes and cardiac troponin Ⅰ (cTnI).The time for ventilator treatment,duration of stay in the intensive care unit and duration of stay in hospital were recorded.Results Compared with group C,the activities of serum creatine kinase,creatine kinase isoenzyme-MB,aspartate aminotransferase and lactate dehydrogenase and cTnI concentrations were significantly increased at T3 and T4 (P ＜ 0.05) and no significant changes were found at T1 in group E (P ＞ 0.05).The parameters mentioned above were significantly higher at T3 and T4 than at T1 in the two groups (P ＜ 0.05).The time for ventilator treatment,duration of stay in the intensive care unit and duration of stay in hospital were significantly shortened in group E as compared with group C (P ＜ 0.05 or 0.01).Conclusion Edaravone 60 mg infused before OPCABG can provide effective myocardial protection in patients.