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重组人超氧化物歧化酶用于心肌保护的临床试验

[A clinical trial of recombinant human superoxide dismutase for myocardial protection].

作者信息

Takemura T

机构信息

Department of Cardiovascular Surgery, Tokyo Women's Medical College, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1993 Feb;41(2):247-53.

PMID:8473790
Abstract

This study explored the effect of recombinant human superoxide dismutase (rh-SOD) for the prevention of reperfusion injury and the myocardial protection in open heart surgery. Fifty one patients undergoing cardiac valve replacements were divided into the following four groups; group I (n = 14), 50 ml of saline was administered through the aortic root into the coronary artery a few minutes prior to reperfusion; group II (n = 14), rh-SOD (10000 U/kg) was administered as the same manner as the group I; group III (n = 13), rh-SOD (10000 U/kg) was administered into the cardiopulmonary circuit a few minutes prior to reperfusion; group IV (n = 10), rh-SOD (3000 U/kg) was administered as the same manner as the group III. They received continuous perfusion of cold blood and GIK solution every 30 minutes. Arterial blood samplings for Creatine phosphokinase MBisozyme (CPK-MB), alpha-hydroxy lactic acid dehydrogenase (HBDH), thiobarbituric acid reactive substance (TBA) were measured up to 24 hours after the reperfusion. CPK-MB values at 12 and 24 hours after reperfusion, and HBDH value at 12 hours after the reperfusion in group II were significantly lower than those in group I. CPK-MB and HBDH levels in group III were lower than group I without statistically significant differences. TBA levels in group II at 9 and 12 hours after the reperfusion were lower than these in group I. TBA levels were not statistically different in group I, III and IV. These results suggest that administration of rh-SOD at the time of reperfusion may be required to prevent reperfusion injury in open heart surgery.

摘要

本研究探讨重组人超氧化物歧化酶(rh-SOD)在心脏直视手术中预防再灌注损伤及心肌保护的作用。51例行心脏瓣膜置换术的患者被分为以下四组:第一组(n = 14),在再灌注前几分钟经主动脉根部向冠状动脉注入50 ml生理盐水;第二组(n = 14),以与第一组相同的方式注入rh-SOD(10000 U/kg);第三组(n = 13),在再灌注前几分钟将rh-SOD(10000 U/kg)注入心肺循环;第四组(n = 10),以与第三组相同的方式注入rh-SOD(3000 U/kg)。他们每30分钟接受一次冷血和GIK溶液的持续灌注。在再灌注后24小时内采集动脉血样,检测肌酸磷酸激酶同工酶MB(CPK-MB)、α-羟丁酸脱氢酶(HBDH)、硫代巴比妥酸反应物质(TBA)。第二组再灌注后12小时和24小时的CPK-MB值以及再灌注后12小时的HBDH值显著低于第一组。第三组的CPK-MB和HBDH水平低于第一组,但无统计学差异。第二组再灌注后9小时和12小时的TBA水平低于第一组。第一组、第三组和第四组的TBA水平无统计学差异。这些结果表明,在心脏直视手术中,可能需要在再灌注时给予rh-SOD以预防再灌注损伤。

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