Dingchao H, Zhiduan Q, Liye H, Xiaodong F
Department of Cardiovascular Surgery, First Medical College of Xian Medical University, Peoples Republic of China.
Thorac Cardiovasc Surg. 1994 Oct;42(5):276-8. doi: 10.1055/s-2007-1016504.
The protective effects of high-dose ascorbic acid (250 mg/kg) on the myocardium were observed in 85 patients undergoing Cardiopulmonary Bypass (CPB). The changes in serum Malonyldialdehyde (MDA). Creatine Phosphokinase (CPK), Creatine Phosphokinase isozyme (CPK-MB) and Lactic Dehydrogenase (LDH) in group B (n = 45, receiving ascorbic acid) were lower (p < 0.05) than in group A (n = 40, no ascorbic acid) during and after CPB. The MDA remained at a higher level two days postoperatively; CPK and CPK-MB, the sensitive and specific reflectors of myocardial injury, recovered very slowly in the control group (A) after the operation. The hearts in all the patients of group B resuscitated automatically intraoperatively while five cases (12.5%) needed defibrillation in group A. The cardiac index (CI) measured in ICU in group B was higher than in group A (p < 0.05). The patients needed shorter ICU and hospital stays in group B than in group A. The results indicate that ascorbic acid can act as a scavenger of free radicals to decrease the peroxidation of the lipids present in the cell membrane and remove the radicals to protect the myocardium from ischemia-reperfusion injury effectively during and after open-heart operation.
在85例接受体外循环（CPB）的患者中观察了高剂量抗坏血酸（250mg/kg）对心肌的保护作用。B组（n = 45，接受抗坏血酸）在CPB期间及之后血清丙二醛（MDA）、肌酸磷酸激酶（CPK）、肌酸磷酸激酶同工酶（CPK-MB）和乳酸脱氢酶（LDH）的变化低于A组（n = 40，未接受抗坏血酸）（p < 0.05）。术后两天MDA仍处于较高水平；CPK和CPK-MB作为心肌损伤敏感且特异的指标，在对照组（A组）术后恢复非常缓慢。B组所有患者心脏在术中自动复跳，而A组有5例（12.5%）需要除颤。B组在重症监护病房（ICU）测得的心脏指数（CI）高于A组（p < 0.05）。B组患者在ICU和住院的时间比A组短。结果表明，抗坏血酸可作为自由基清除剂，减少细胞膜中脂质的过氧化，并清除自由基，从而在心脏直视手术期间及术后有效保护心肌免受缺血-再灌注损伤。
