国际麻醉学与复苏杂志   2019, Issue (8): 0-0
    
血必净注射液减轻心脏手术患者体外循环心脏损伤
赵小晴, 孙海彬, 朱敬丽, 高伟1()
1.哈尔滨医科大学第二附属医院麻醉科
Xuebijing injection attenuates cardiac injury in patients undergoing cardiopulmonary bypass
 全文:
摘要:

目的 观察血必净(Xuebijing, XBJ)对CPB患者的心脏保护作用。 方法 60例CPB下行心脏手术的患者通过随机抽样方法分为XBJ组和对照组(C组),每组30例。XBJ组患者于术前12 h、手术开始时以及手术开始后12 h静脉注射XBJ注射液;C组在相同时间点注射生理盐水。首次注射XBJ前,术后0、12、24、48 h测定患者动脉血气分析结果、外周血中炎症因子和氧化应激相关指标。记录患者ICU机械通气时间、ICU治疗时间、术后至出院时间。 结果 与C组比较,XBJ组患者氧合指数(arterial partial pressure of oxygen/fraction of inspiratory oxygen, PaO2/FiO2)、IL-10浓度升高,术后肌钙蛋白I (troponin I, TnI)、肌酸激酶同工酶(creatine kinase isoenzyme, CK-MB)、丙二醛(malonaldehyde, MDA)、8-异前列烷、TNF-α、IL-1β、IL-8浓度降低(P<0.05);XBJ组患者ICU机械通气时间、ICU治疗时间和术后至出院时间短于C组,但差异无统计学意义(P>0.05)。 结论 围手术期使用XBJ可通过抗炎和抗氧化应激反应减轻CPB过程中的心脏损伤。

关键词: 血必净注射液; 体外循环; 心脏损伤
Abstract:

Objective To estimate the effect of Xuebijing(XBJ) injection on cardiac injury associated with cardiopulmonary bypass (CPB). Methods Sixty CPB patients undergoing cardiac surgery were randomly divided into a control group and an XBJ group (n=30). Patients in the XBJ group received XBJ 12 h prior to operation, at the beginning of operation, and 12 h after the second injection, while those in the control group was given normal saline alone. Their arterial blood gas analysis, inflammatory factors in peripheral blood and related indicators of oxidative stress were measured before the first injection of XBJ(as a baselin value) and after surgery 0, 12, 24, 48 h. The time of mechanical ventilation in intensive care unit (ICU), and treatment duration and discharge time were recorded. Results  Compared with the control group, XBJ greatly increased arterial partial pressure of oxygen/fraction of inspiratory oxygen (PaO2/FiO2) and interleukin(IL)-10 amounts, but decreased the levels of troponin I (TnI), creatine kinase isoenzyme (CK-MB), malonaldehyde (MDA), 8-isoprostane, tumor necrosis factor-α (TNF-α), IL-1β and IL-8 after operation (all P<0.05). The XBJ group presented shorter time of mechanical ventilation in ICU, treatment duration and discharge time than the control group, without statistical differences. Conclusions XBJ can protect cardiac injury induced by CPB, which may be associated with the down-regulation of inflammatory mediators and oxidative response.

Key words: Xuebijing injection; Cardiopulmonary bypass; Cardiac injury