Emadi Nafiseh, Nemati Mohammad Hasan, Ghorbani Mohammad, Allahyari Elahe
Shiraz University of Medical Sciences Blood Circulation Technology Shiraz Iran Blood Circulation Technology, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz University of Medical Sciences Department of Heart Surgery Shiraz Iran Department of Heart Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Braz J Cardiovasc Surg. 2019 Dec 1;34(5):517-524. doi: 10.21470/1678-9741-2018-0312.
To evaluate the effect of high-dose vitamin C on cardiac reperfusion injury and plasma levels of creatine kinase-muscle/brain (CK-MB), troponin I, and lactate dehydrogenase (LDH) in patients undergoing coronary artery bypass grafting (CABG).
This is a double-blind randomized clinical trial study. Fifty patients (50-80 years old) who had CABG surgery were selected. The intervention group received 5 g of intravenous vitamin C before anesthesia induction and 5 g of vitamin C in cardioplegic solution. The control group received the same amount of placebo (normal saline). Arterial blood samples were taken to determine the serum levels of CK-MB, troponin I, and LDH enzymes. Left ventricular ejection fraction was measured and hemodynamic parameters were recorded at intervals.
High doses of vitamin C in the treatment group led to improvement of ventricular function (ejection fraction [EF]) and low Intensive Care Unit (ICU) stay. The cardiac enzymes level in the vitamin C group was lower than in the control group. These changes were not significant between the groups in different time intervals (anesthesia induction, end of bypass, 6 h after surgery, and 24 h after surgery) for CK-MB, LDH, and troponin I. Hemodynamic parameters, hematocrit, potassium, urinary output, blood transfusion, arrhythmia, and inotropic support showed no significant difference between the groups.
Vitamin C has significantly improved the patients' ventricular function (EF) 72 h after surgery and reduced the length of ICU stay. No significant changes in cardiac biomarkers, including CK-MB, troponin I, and LDH, were seen over time in each group.
IRCT2016053019470N33.
评估大剂量维生素C对冠状动脉搭桥术（CABG）患者心脏再灌注损伤以及肌酸激酶同工酶-肌肉/脑型（CK-MB）、肌钙蛋白I和乳酸脱氢酶（LDH）血浆水平的影响。
这是一项双盲随机临床试验研究。选取50例年龄在50至80岁之间接受CABG手术的患者。干预组在麻醉诱导前静脉注射5 g维生素C，并在心脏停搏液中加入5 g维生素C。对照组给予等量的安慰剂（生理盐水）。采集动脉血样本以测定CK-MB、肌钙蛋白I和LDH酶的血清水平。定期测量左心室射血分数并记录血流动力学参数。
治疗组大剂量维生素C可改善心室功能（射血分数[EF]）并缩短重症监护病房（ICU）住院时间。维生素C组的心肌酶水平低于对照组。在不同时间间隔（麻醉诱导、体外循环结束、术后6小时和术后24小时），两组之间CK-MB、LDH和肌钙蛋白I的这些变化无显著差异。血流动力学参数、血细胞比容、血钾、尿量、输血、心律失常和血管活性药物支持在两组之间无显著差异。
维生素C在术后72小时显著改善了患者的心室功能（EF）并缩短了ICU住院时间。每组中，包括CK-MB、肌钙蛋白I和LDH在内的心脏生物标志物随时间未见显著变化。
IRCT2016053019470N33。
