摘要
目的研究银杏叶提取物(Egb761)对心脏直视手术后心肌缺血再灌注损伤的心肌保护效果。方法20例单纯室间隔缺损患者随机分为对照组(ST.Thomas′s停搏液组)、实验组(ST.Thomas停搏液中加入Egb761,每1000mlST.Thomas停搏液中加入50mlEgb761),每组10例。两组灌注方法及体外循环方法相同。分别于下列时点采取桡动脉血:①作皮肤切口前;②主动脉开放即刻;③再灌注后2h;④再灌注后6h;⑤再灌注后24h。测定血清cTnI、肌酸激酶同工酶(CK MB)水平,同时观察、记录两组患者的体外循环时间、主动脉阻断时间、开放后心脏自动复跳率,并观察手术前后心肌超微结构的变化。结果两组患者体外循环时间及主动脉阻断时间比较差异无显著性(P>0.05)。主动脉开放后所有患者的心脏自动复跳。术前两组患者的血清cTnI、CK MB的水平比较差异无显著性(均为P>0.05)。再灌注后2、6、24h实验组血清cTnI、CK MB的水平明显低于对照组(均为P<0.05)。对照组手术后心肌超微结构损伤较重,实验组则损伤较轻。结论Egb761能减轻心脏直视手术后心肌缺血再灌注损伤。
Objective To study the protective effects of ginkgo biloba extract （Egb761） on myocardial ischemia reperfusion injury in patients undergoing open-heart surgery. Methods 20 patients with pure ventricular septal defect were randomly divided into control group（ST. Thomas cardioplegia, n = 10） and experiment group （ST.Thomas＇s cardioplegia with 50 ml Egb761/L every 1 000 ml ST. Thomas＇ cardioplegia,n = 10）. The perfusion and cardiopulmonary bypass （CPB）were the same in the two groups. The radial arterial blood samples were collected serially from patients at the following time points ：①before operation;②immediately after reperfusion;③2 hours afterreperfusion ;④6 hours after reperfusion;⑤24 hours after reperfusion. The serum cardiac troponin-Ⅰ （cTnl） and crea-tine kinase isoenzyme MB （CK-MB）were measured. The CPB time,cross-clamp time and the incidence of spontane-ous recovery of hearts were recorded. The cardiac ultrastructure was observed. Result The CPB time and the crossclamp time were similar in both groups（P 〉 0.05）. The incidence of spontaneous recovery of heart beating were 100% in both groups. The serum levels of CK-MB and cTnl were not significantly different before operation in two groups （P 〉 0.05） , but they were significantly lower in experiment group than those in control group at 2,6 and 24h after reperfusion,respectively （P 〈0.05）. The myocardial uhrastructure in control group after reperfusion was seriously damaged while the damage in experiment group was slight. Conclusion Egb761 may reduce the myocardial ischemic reperfusion injury of the patients undergoing open-heart surgery.
出处
《中国综合临床》
北大核心
2005年第9期812-814,共3页
Clinical Medicine of China
