参附注射液对心脏瓣膜置换患者脑损伤的影响 .docVIP

参附注射液对心脏瓣膜置换患者脑损伤的影响 邹磊1，刘丹彦，曹宇，吴会生 摘要 目的：观察参附注射液（SFI）用于体外循环心肺转流术（CPB）心脏瓣膜置换术时对患者术中脑氧供需平衡的影响及脑缺血损伤保护作用，探讨其疗效及最佳给药方式。 方法：3２例体外循环下心脏瓣膜置换患者，年龄（25～The effects of Shenfu injection on brain injury in patients undergoing valve replacement ZOU Lei， LIU Dan-yan Department of Anesthesiology,the First Affiliated Hospital , Chongqing Medical University，400016 Abstract Objective：To investigate the effects of Shenfu injection on cerebral oxygen balance and cerebral ischemia-reperfusion injury in patients undergoing valve replacement during cardiopulmonary bypass，so that we can Explore its efficacy and find Reasonable orders of administration. Methods：32 patients undergoing valve replacement，aging 25-54，heart functionⅡ - Ⅲ） level, were randomly divided into four groups with eight cases in each. Patients in group E1 received　SFI１ml·kg-1　before blocking the aorta；Patients in group E２ received　SFI１ml·kg-1　 after opening the aorta；Patients in group E３received　SFI 0. ml·kg-1　 before blocking and after opening the aorta,too. Patients in group C received 0.9％ NaCL. Blood samples were taken from internal jugular vein and arteria radialis after trachea cannula（T1）、10 min after CPB（T2）、cooling stability stage（T3）、recovery temperature to 33℃（T4）、the end of CPB（T5） and 1 hour after the end of CPB（T6）for blood gas analysis.Then，Plasma S100β protein concentration、MDA、Glu and the activity of SOD in jugular vein bulb were determined. Results：The CERO2、SjvO2 changes in Group E1, E2, E3 were stable，moreover，SjvO2 was significantly higher than that of group C (P 0.05).There were no difference in these three groups.In Group E1, E2, E3,the S100β plasma protein and MDA, Glu were lower than these in group C （P 0.05）, and at T6,these indicators were the lowest in E3（P 0.05）; SOD activitysignificantly decreased at the start of CPB in group C（P 0.05）,however,there were no obvious change after giving SFI（P＞0.05），In group E3，SOD had the highest activity at T6（P 0.05）. Conclusion：SFI maintain a