抑肽酶减少非体外循环冠状动脉搭桥术中的心肌损伤

[Aprotinin reduces myocardial injury in the off-pump coronary artery bypass grafting].

作者信息

Yang Yang, Xiao Feng, Chen Hong-yi, Li Yan, Shi Zhi-hui

机构信息

Department of Cardiac Surgery, Peking University First Hospital, Beijing 100034, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2003 Dec 10;83(23):2061-3.

PMID:14703417

Abstract

OBJECTIVE

To investigate the effect of aprotinin on the myocardial injury during the off-pump coronary artery bypass grafting (OPCAB).

METHODS

Twenty-four patients undergoing OPCAB randomly were of 12 patients divided into two groups: aprotinin group and Control group (n = 12). In the aprotinin group a loading dose (2 x 10(6) KIU) was administered within the first 30 minutes after the induction followed by continuous infusion of 0.5 x 10(6) KIU/h throughout the operation. The plasma myocardial injury markers CK-MB and cTnI were measured at the four points: (1) After induction; (2) 1 hour after coronary anastomosis; (3) 6 hours and (4) 24 hours after the operation. The blood loss was recorded by autotransfusion in the operation, and the drainage immediately, 6 hours, and 24 hours after the operation.

RESULT

Myocardial injury markers CK-MB and cTnI increased significantly after the anastomosis in each group; cTnI was lower in the aprotinin group than in the control group at the third and forth points (P < 0.05). The post-operative drainage after 6 hours and 24 hours were lower in the aprotinin group than in control group (P < 0.05).

CONCLUSIONS

There is the myocardial injury during OPCAB. Aprotinin can reduce the myocardial injury during OPCAB.

摘要

目的

探讨抑肽酶在非体外循环冠状动脉旁路移植术（OPCAB）中对心肌损伤的影响。

方法

24例行OPCAB的患者随机分为两组，每组12例：抑肽酶组和对照组。抑肽酶组在诱导后最初30分钟内给予负荷剂量（2×10⁶KIU），随后在整个手术过程中以0.5×10⁶KIU/h的速度持续输注。在四个时间点测定血浆心肌损伤标志物CK-MB和cTnI：（1）诱导后；（2）冠状动脉吻合术后1小时；（3）术后6小时；（4）术后24小时。手术中通过自体输血记录失血量，并记录术后即刻、6小时和24小时的引流量。