丙泊酚联合贝那普利预处理对体外循环下冠脉搭桥术患者心肌缺血再灌注损伤保护作用探讨.docVIP

丙泊酚联合贝那普利预处理对体外循环下冠脉搭桥术患者心肌缺血再灌注损伤的保护作用探讨 　　[摘要] 目的 分析丙泊酚联合贝那普利预处理对体外循环下冠脉搭桥术患者心肌缺血再灌注损伤的保护作用。 方法 选择2014年9月～2016年10月浙江绿城心血管病医院行体外循环下冠脉搭桥术的94例患者，采用随机数字表法分为两组。观察组47例，术前1周服用贝那普利，术中持续应用丙泊酚麻醉；对照组47例，术中应用丙泊酚。观察两组不同时段的心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）、血浆可溶性细胞间黏附分子-1（sICAM-1）水平以及使用正性肌力药患者例数，比较两组术后不良事件发生情况、自动复跳情况、左室射血分数。 结果 观察组术后6、12、24、72 h的cTnI、CK-MB、sICAM-1均低于对照组，心脏复跳时、术后12、24、48 h使用多巴胺、肾上腺素患者例数均少于对照组，术后心肌缺血、房颤、再灌注损伤所致再灌注心律失常的发生率均低于对照组，自动复跳率、左室射血分数均高于对照组，差异有统计学意义（P 0.05）。 结论 丙泊酚联合贝那普利预处理可有效减轻体外循环下冠脉搭桥术患者心肌缺血再灌注损伤，具有临床推广价值。 　　[关键词] 丙泊酚；贝那普利；体外循环；冠脉搭桥术；缺血再灌注损伤 　　[中图分类号] R614 [文献标识码] A [文章编号] 1673-7210（2017）05（b）-0048-04 　　[Abstract] Objective To investigate the protective effect of Propofol combined with Benazepril pretreatment on myocardial ischemia-reperfusion injury in patients undergoing coronary artery bypass grafting under cardiopulmonary bypass. Methods From September 2014 to October 2016， 94 patients underwent coronary artery bypass grafting were divided into two groups according to random number table： observation group （47 cases）， Benazepril oral before surgery 1 week， intraoperative Propofol anesthesia was continuously taken； control group （47 cases）， intraoperative Propofol was taken. The levels of cTnI， CK-MB activity， sICAM-1 level and the number of patients with positive inotropic drugs were observed in two groups were observed. The incidence of adverse events， auto-resuscitation and left ventricular ejection fraction in two groups were compared. Results After surgery 6， 12， 24， 72 h， cTnI， CK-MB activity， sICAM-1 of observation group wrer lower than control group， after cardiopulmonary resuscitation 12， 24， 48 h， the number of patients with positive inotropic drugs were less than control group， the incidence of postoperative myocardial ischemia and atrial fibrillation was lower than the control group， the rates of auto resuscitation and left ventricular ejection fraction were higher than those of the control group， the differences were statistically signifi