CAJ | 학술논문

目的：对心脏手术后应用谷氨酰胺双肽进行随机对照研究，观察谷氨酰胺对心肌损伤及左室收缩功能的影响。方法选择体外循环心脏手术患者共60例，随机分为试验组与对照组各30例，试验组术后第1天起静脉补充谷氨酰胺双肽，连续7 d；对照组给予等量复方氨基酸，观察并比较血流动力学、超声多普勒测定二尖瓣环心肌收缩期峰值速度（Systolic myocardial velocity， Sa）、血清肌钙蛋白T水平、机械通气时间、ICU住院时间。结果两组血流动力学指标差异无统计学意义，血清肌钙蛋白水平组间差异有统计学意义（P＝0．0001），12 h及24 h试验组低于对照组（P＜0．05），左室射血分数（LVEF）两组差异均无统计学意义，Sa术后第3天试验组高于对照组（P＜0．05），机械通气时间、ICU住院时间差异无统计学意义。结论心脏手术后静脉补充谷氨酰胺双肽具有心肌保护作用，可改善心肌损伤，加快术后心肌收缩功能恢复。
목적：대심장수술후응용곡안선알쌍태진행수궤대조연구，관찰곡안선알대심기손상급좌실수축공능적영향。방법선택체외순배심장수술환자공60례，수궤분위시험조여대조조각30례，시험조술후제1천기정맥보충곡안선알쌍태，련속7 d；대조조급여등량복방안기산，관찰병비교혈류동역학、초성다보륵측정이첨판배심기수축기봉치속도（Systolic myocardial velocity， Sa）、혈청기개단백T수평、궤계통기시간、ICU주원시간。결과량조혈류동역학지표차이무통계학의의，혈청기개단백수평조간차이유통계학의의（P＝0．0001），12 h급24 h시험조저우대조조（P＜0．05），좌실사혈분수（LVEF）량조차이균무통계학의의，Sa술후제3천시험조고우대조조（P＜0．05），궤계통기시간、ICU주원시간차이무통계학의의。결론심장수술후정맥보충곡안선알쌍태구유심기보호작용，가개선심기손상，가쾌술후심기수축공능회복。
Objectives To investigate the effects of glutamine dipeptide on myocardial injury andleft ventricular systolic function after cardiac surgery.Method A total of 60 patients who underwent cardiac surgery with cardiopulmonary bypass(CPB)were randomized into two groups(n =30 in each).Thestudy group received intravenous administration of glutamine dipeptide for 7 days and the control group received compound amino acids as controls.Hemodynamic variations,peak systolic myocardial velocity(Sa)of the mitral annulus,serum troponin T(TnT),mechanical ventilation duration and ICU hospitalizationwere recorded and compared between groups.Results There were no significant differences in hemodynamic variations and left ventricular ejection fraction(LVEF).In the study group,the level of serum TnTdecreased significantly within 12 and 24 hours after glutamine administration(P <0.05),and Sa improvedsignificantly on the third day(P <0.05).No significant differences were found in mechanical ventilationduration and ICU hospitalization.Conclusion Intravenous administration of glutamine dipeptide has cardioprotective effects in patients after cardiac surgery,which may improve myocardial injury and speed systolic function recovery.