腺苷静脉预处理对缺血/再灌注心肌的保护作用

目的：比较腺苷静脉预处理在体外循环心内直视手术中对缺血/再灌注心肌的保护作用。方法：将在体外循环下行心内直视术非紫绀型先心病及瓣膜病患者30例,随机分为两组（每组15例）。A组：腺苷静脉预处理组;B组：空白对照组;两组其他处理相同。分别于阻断升主动脉前、阻断升主动脉30分钟、开放升主动脉15分钟及术后24小时检测血清肌酸激酶同工酶-MB（CK-MB）、乳酸脱氢酶（LDH）水平。结果：两组血清CK-MB、LDH水平均有明显升高,实验组术中、术后血清CK-MB、LDH水平均明显低于对照组（P〈0.05）。结论：腺苷静脉预处理能模拟缺血预处理（IPC）的心肌保护效应,在体外循环心内直视手术中对缺血/再灌注心肌具有保护作用。

Protective effect of intravenous preconditioning with adenosine in myocardial cells after ischemia and reperfusion

Objective:To investigate the ischemia and reperfusion myocardial protective effects of adenosine intravenous preconditioning in patients of undergoing open heart surgery with cardiopulmonary bypass(CPB).Methods:Thirty patients with non-cyanotic congenital heart disease and cardiac valve replacement were randomly divided into two groups in which the group A(n=15) was intravenously injected with adenosine in jugular vein and the group B(n=15) was not injected with adenosine as control,which were the same in other experimental conditions.The level of plasma creatine kinase MB(CK-MB) and lactate dehydrogenase(LDH)was respectively measured in each group before CPB,30 minutes after aorta clamping,15 minutes after aorta declamping and 24 hours after operation.Results:The level of plasma CK-MB and LDH increased significantly in both of the group in which it was notably lower in experiment group than control group during operation and after operation(P<0.05).Conclusion:Adenosine precondition can imitate the effect of myocardial preservation like intravenous preconditioning in patients of undergoing open heart surgery with cardiopulmonary bypass.