摘要
目的观察无创性肢体缺血预处理对体外循环心脏直视手术中心肌缺血-再灌注损伤的影响。方法将20例体外循环心脏手术患者随机分为2组:N组患者于麻醉诱导后用止血带阻断双上肢血流8 min,复灌5 min,反复3个循环,C组不予缺血预处理。分别于麻醉诱导后即刻(T1)、主动脉夹闭后30 min(T2)及主动脉开放后30 min(T3)、120 min(T4)、24 h(T5)抽取中心静脉血检测血浆中血栓素B2(TXB2)、6-酮-前列腺素F1α(6-Ket-PGF1α)、8-异前列腺素F2α(8-Iso-PGF2α)含量,并计算TXB2/6-Ket-PGF1α值。结果T2、T3时间点,2组患者血浆中各指标均较术前大幅增加(P均<0.01)。T5时间点,C组患者血浆中8-Iso-PGF2α含量及TXB2/6-Ket-PGF1α值明显下降,但仍明显高于术前水平(P均<0.05);而N组患者血浆中上述2种指标与术前比较无显著性差异。T3、T4、T5时间点N组的TXB2/6-Ket-PGF1α值均低于C组(P均<0.05);T4时间点N组的血浆8-Iso-PGF2α水平低于C组(P<0.05);而在T5时间点,N组血浆中6-Ket-PGF1α含量高于C组(P<0.05)。结论无创性肢体缺血预处理可通过改善TXB2/6-Ket-PGF1α比例失衡,抑制氧化应激来减轻心肌缺血再灌注损伤,发挥心肌保护作用。
Objective It is to observe the influence of noninvasive limb ischemic preconditioning （NPC） on myocardial ischemia-reperfusion injury during cardiopulmonary bypass cardiac surgery. Methods 20 patients required cardiopulmonary bypass cardiac surgeries were randomly divided into 2 groups. In group N, two tourniquets wrapped around both upper extremities of each patient were inflated for 8 min and deflated 5 min for three times after anesthesia. The other procedures were the same as group C. Blood samples were collected from central vein respectively before operation（Tla）, 30 min after aortic clamp（T2）, 30 min（T3）, 120 min（T4）, 24 h （T5） after aortic opened to measure the concentration of TXB2, 6- Ket- PGF1α, 8 - Iso - PGF2α and calculate ratio of TXP,2/6 - Ket - PGF1α. Results Plasma concentration of TXB2, 6 - Ket - PGF1α, 8 - Iso- PGF2α and the ratio of TXB2/6 - Ket- PGF1α. raised significantly in both groups at T2 and T3 （P 〈 0.01 ）. During reperfusion, the ratio of TXt32/6 - Ket - PGF1α（from T3 to T5） in group N decreased more rapidly than those in group C, the level of 8 - Iso- PGF2αin group N was lower than that in group C at T4（P〈0.05）. While at T5, the level of 6 - Ket- PGF1α in group N was higher than that in group C（ P 〈 0.05 ）. Conclusion Noninvasive limb ischemic precondition-ng can relieve myocardium ischemic-reperfusion injury to protect myocardium by improving disbalance of TXB2/6 - Ket- PGF1α, and inhibiting oxidative stress.
出处
《现代中西医结合杂志》
CAS
2009年第22期2619-2621,2647,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
关键词
肢体缺血预处理
体外循环
缺血再灌注损伤
limb ischemic preconditioning
myocardium ischemic-reperfusion injury
extracorporeal circulation
