葛根素对高血压患者心肌损伤的保护作用.docVIP

葛根素对高血压患者围手术期心肌损伤的保护作用 吴先平1 冯俊光2 陈浩铭1 程芳1 张丽蓓1 韦志军1陈伟才3 1. 广东省佛山市顺德区中西医结合医院麻醉科，广东佛山 528333； 2. 广东省佛山市顺德区中西医结合医院内三科，广东佛山 528333； 3. 广东省佛山市顺德区中西医结合医院放免中心，广东佛山 528333 [摘要] 目的：通过检测手术前后心肌肌钙蛋白I(cTnI) 和磷酸肌酸激酶同功酶(CK-MB)的变化, 探讨葛根素对高血压患者围手术期心肌损伤的保护作用。方法：34例原发性高血压全麻病人，随机均分为葛根素组和对照组，分别于诱导前1h静脉输注中药葛根素注射液500mg或生理盐水。于麻醉诱导前和手术后2h采血检测血清cTnI 和CK-MB浓度。结果：术后2h两组cTnI和CK-MB浓度均有不同程度的增加(P0.05)；术后2h葛根素组cTnI和CK-MB浓度显著低于对照组(P0.05)。结论：手术和麻醉应激能够导致对高血压患者心肌损伤，在围手术期应用葛根素对高血压患者心肌损伤有显著的保护作用。 [关键词] 葛根素 心肌保护 心肌肌钙蛋白I 磷酸肌酸激酶同功酶 注：本项目为广东省中医药管理局2003-2004年度立项课题（编号：403041）。 Protective effects of puerarin on myocardium for patients with hypertension during operation WU Xian-ping, FENG Jun-guang, CHEN Hao-ming, etal. Department of Anesthesiology, Shunde Hospital of Integrated Traditional and Western Medicine, Foshan (528333) Objective: To observe the cardioprotective effects of puerarin by comparing change of plasma concentration of cTnI and CK-MB during surgery. Methods: 34 patients with hypertension undergoing general anesthesia were randomly divided into control group and puerarin group (500mg puerarin was given 1h before induction of general anesthesia). The cTnI and CK-MB were measured before operation and 2h after operation respectively. Results: The plasma concentration of cTnI and CK-MB in both two groups 2h after operation increased in different extent (P0.05); The plasma concentration of cTnI and CK-MB in puerarin group were much lower than that in control group (P0.05). Conclusion: Puerarin can reduce myocardial injury induced by the cardiovascular response to general anesthesia and operation. Key words puerarin, myocardial protection, cTnI, CK-MB 由于麻醉及手术创伤导致机体出现强烈的应激反应，使高血压患者在围术期容易发生心肌缺血[1]，导致心肌损伤。中药葛根素(puerarin)具有硝酸酯类和选择性心肌β受体阻滞剂的优点[2]，它能抑制围术期的应激反应[3]。本研究将通过检测围术期心肌肌钙蛋白I(cTnI) 这一心肌特异性和敏感性最强指标[4]的浓度变化，探讨葛根素对高血压患者围术期心肌损伤的保护作用。 资料与方法 1 一般资料　34例原发性高血压病病人，男24例，女10例，年龄42岁-87岁，体重45kg-80kg。均为选择性胸腹部手术或骨科手术，手术当天未用降压药治疗。按手术的先后顺序随机分为葛根素组和对照组，每组各17例。两组性别、年龄、体重及手术种类和手术时间比较无统计学意义（P0.05）。 2 治疗方