二磷酸果糖在冠脉搭桥术中对心肌保护作用.docVIP

二磷酸果糖在冠脉搭桥术中对心肌保护作用 　 【关键词】; 肌酸激酶同工酶 毕业论文 ; 摘要：目的; 评估1，6二磷酸果糖(fructose1,6diphosphate, FDP)在冠状动脉搭桥术中对心肌的保护作用。方法; 随机选取30例冠心病患者，分为实验组和对照组，每组15例。实验组于术前三天及手术当日给予FDP，对照组给予生理盐水。分别于麻醉诱导后(T0)，再灌注后1h(T1)、4h(T2)、24h(T3)及48h(T4)，测定血浆肌钙蛋白I(cardiac troponin I, cTnI)、肌酸激酶同工酶(creatine kinase MB, CKMB)、超氧化物歧化酶(superoxide dismutase, SOD)及丙二醛浓度(malondiadehyde, MDA)。结果; 实验组于T1、T2、T3三个时点CKMB及cTnI浓度均显著低于对照组(Plt;0.05)，T1及T2两个时点MDA浓度明显低于对照组(Plt;0.05)。结论; FDP能够减轻由脂质过氧化反应介导的心肌缺血再灌注损伤，有助于缺血再灌注后心功能的恢复及改善。 毕业论文 　　关键词：1，6二磷酸果糖；肌钙蛋白I；肌酸激酶同工酶；氧自由基；冠脉搭桥术 毕业论文 　　　ABSTRACT: Objective; To investigate the cardioprotective effects of fructose1,6diphosphate on myocardium during coronary artery bypass graft. Methods; A total of 30 patients were treated with coronary artery bypass graft (CABG) and divided into group A (treated group) and group B (control group) randomly. Each group included 15 patients. In the treated group, patients were treated with FDP three days before CABG and treated with FDP before cardiopulmonary bypass (CPB). FDP was replaced by 0.154mol/L NaCl of the same volume in control group. Blood samples were collected from all patients after induction and at 1h, 4h, 24h and 48h after aortic declamping to measure the serum concentration of cTnI, CKMB, SOD and MDA. Results; The levels of CKMB and cTnI at 1h, 4h, 24h and MDA at 1h, 4h after reperfusion were significantly lower in the treated group than those in the control group(Plt;0.05). The concentration of MDA at T1 and T2 was significantly lower than that of the control group (Plt;0.05). Conclusion; FDP can effectively reduce myocardial ischemia reperfusion injury caused by lipsuperoxidized reaction. Therefore, FDP has a desirable myocardial protective effect on patients undergoing CABG. 毕业论文 　　KEY WORDS: fructose1,6diphosphate; cTnI; CKMB; oxygen free radical; CABG 毕业论文 　　冠状动脉搭桥术(coronary artery bypass graft, CABG)是目前治疗冠心病最重要的方法之一。CABG可增加围术期心肌损害和心功能不全的危险。 其围术期的心肌损害主要表现为典型的缺血再灌注损伤。针对如何预防缺血再灌注损伤已经开展了大量研究。一个较为全面的方法就是直接增加高能磷酸物的