丹红注射液对体外循环下冠状动脉搭桥术患者的脑保护作用
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摘要
目的探讨丹红注射液对体外循环下冠状动脉搭桥术患者的脑保护作用。方法选取2016年1月至2017年5月在本院接受择期体外循环下冠状动脉搭桥术的患者48例,根据随机数表法将其分为对照组和观察组,每组各24例。观察组患者在预充以及开放主动脉时泵入丹红注射液1.5 ml/kg,对照组患者接受同等剂量的生理盐水。比较两组患者体外循环时间、主动脉阻断时间、手术时间、清醒时间以及手术开始前(T1)、复温至36℃时(T2)、停体外循环后30 min(T3)、停体外循环后6 h(T4)超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-8(interleukin-8,IL-8)、白细胞介素-10(interleukin-10,IL-10)水平变化。结果观察组患者清醒时间显著短于对照组(P <0.05),T2、T3、T4时间点血浆SOD水平均显著高于同期对照组(均P <0.05),血浆MDA水平均显著低于同期对照组(均P <0.05),T3、T4时间点TNF-α、IL-6、IL-8水平均显著低于同期对照组(均P <0.05),T4时间点IL-10水平显著高于同期对照组(P <0.05)。结论丹红注射液对体外循环下冠状动脉搭桥手术患者具有显著的脑保护作用。
Objective To investigate the protective effect of Danhong injection on brain protection undergoing coronary artery bypass graft under extracorporeal circulation. Method From January 2016 to May 2017, 48 cases of underwent elective extracorporeal circulation coronary artery bypass graft in our hospital were selected. According to the random number method, they were divided into control group and observation group with 24 cases each. Observation group patients were pumped with Danhong injection 1.5 ml/kg during pre-filling and open aorta, and control group patients received the same dose of normal saline. The extracorporeal circulation time, aortic occlusion time, operation time and awake time were compared between the two groups. The changes of superoxide dismutase(SOD), malondialdehyde(MDA), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interle ukin-8(IL-8) and interleukin-10(IL-10) at before surgery(T1), rewarming to 36℃(T2), 30 min after cardiopulmonary bypass(T3), and 6 h after cardiopulmonary bypass(T4) were compared between the two groups. Result The awake time of observation group was significantly shorter than that of control group(P < 0.05). The levels of plasma SOD at the T2, T3 and T4 time points of observation group were significantly higher than those in control group(all P < 0.05), and the plasma MDA levels were significantly lower than those in control group(all P < 0.05). The levels of TNF-α, IL-6 and IL-8 at the T3 and T4 time points of observation group were significantly lower than those in control group(all P < 0.05). The level of IL-10 at the T4 time points of observation group was significantly higher than that in control group(P < 0.05). Conclusion Danhong injection has significant brain protection effect on patients undergoing coronary artery bypass graft under extracorporeal circulation.
Objective To investigate the protective effect of Danhong injection on brain protection undergoing coronary artery bypass graft under extracorporeal circulation. Method From January 2016 to May 2017, 48 cases of underwent elective extracorporeal circulation coronary artery bypass graft in our hospital were selected. According to the random number method, they were divided into control group and observation group with 24 cases each. Observation group patients were pumped with Danhong injection 1.5 ml/kg during pre-filling and open aorta, and control group patients received the same dose of normal saline. The extracorporeal circulation time, aortic occlusion time, operation time and awake time were compared between the two groups. The changes of superoxide dismutase(SOD), malondialdehyde(MDA), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), interle ukin-8(IL-8) and interleukin-10(IL-10) at before surgery(T1), rewarming to 36℃(T2), 30 min after cardiopulmonary bypass(T3), and 6 h after cardiopulmonary bypass(T4) were compared between the two groups. Result The awake time of observation group was significantly shorter than that of control group(P < 0.05). The levels of plasma SOD at the T2, T3 and T4 time points of observation group were significantly higher than those in control group(all P < 0.05), and the plasma MDA levels were significantly lower than those in control group(all P < 0.05). The levels of TNF-α, IL-6 and IL-8 at the T3 and T4 time points of observation group were significantly lower than those in control group(all P < 0.05). The level of IL-10 at the T4 time points of observation group was significantly higher than that in control group(P < 0.05). Conclusion Danhong injection has significant brain protection effect on patients undergoing coronary artery bypass graft under extracorporeal circulation.
引文
[1]崔小英,于建设,都义日,等.体外循环下脑损伤与围术期脑保护[J].河北医药,2016,41(3):430-435.
[2]Bishop H,Middleton B.Cardiopulmonary bypass[J].Surgery(Oxford),2018,36(2):63-67.
[3]Guo H,Li MJ,Liu QQ,et al.Danhong injection attenuates ischemia/reperfusion-induced brain damage which is asso ciating with Nrf2 levels in vivo and in vitro[J].Neurochem Res,2014,39(9):1817-1824.
[4]张志华.丹红注射液治疗不稳定性心绞痛42例临床分析[J].国际心血管病杂志,2017,44(S1):151.
[5]王尧,王涛.体外循环脑损伤与脑保护研究进展[J].岭南现代临床外科,2014,14(6):704-707.
[6]Lomivorotov VV,Shmyrev VA,Ponomarev DN,et al.Influence of remote ischemic preconditioning on brain injury markers dynamics during cardiopulmonary bypass[J].Anesteziol Reanimatol,2015,60(1):33-38.
[7]Bronicki RA,Hall M.Cardiopulmonary Bypass-Induced Inflammatory Response:Pathophysiology and Treatment[J].Pediatr Crit Care Med,2016,17(8 Suppl 1):S272-S278.
[8]岳强,宋心南,林高翔.三七总皂苷对体外循环致脑损伤氧化应激的影响及机制探讨[J].华夏医学,2015,28(6):25-28.
[9]Xu HY,Rong XS,Wang DP,et al.Effect of urinary trypsin inhibitor on inflammatory cytokines and organ function in patients with cardiopulmonary bypass[J].Eur Rev Med Pharmacol Sci,2017,21(9):2220-2225.
[10]于志伟,姚晓伟,潘军强.丹红注射液对兔主动脉动脉粥样硬化斑块内脂联素表达的影响[J].陕西中医,2016,37(10):1436-1437.
[11]朱付平,周钰龙,李晓军,等.桃红四物液对肢体缺血再灌注损伤大鼠血清SOD与MDA的影响[J].中医药导报,2015,11(21):17-19.
[12]胡蓉,林高翔.体外循环致脑损伤的炎性介质机制研究进展[J].医药前沿,2014,20(34):350-351.
[2]Bishop H,Middleton B.Cardiopulmonary bypass[J].Surgery(Oxford),2018,36(2):63-67.
[3]Guo H,Li MJ,Liu QQ,et al.Danhong injection attenuates ischemia/reperfusion-induced brain damage which is asso ciating with Nrf2 levels in vivo and in vitro[J].Neurochem Res,2014,39(9):1817-1824.
[4]张志华.丹红注射液治疗不稳定性心绞痛42例临床分析[J].国际心血管病杂志,2017,44(S1):151.
[5]王尧,王涛.体外循环脑损伤与脑保护研究进展[J].岭南现代临床外科,2014,14(6):704-707.
[6]Lomivorotov VV,Shmyrev VA,Ponomarev DN,et al.Influence of remote ischemic preconditioning on brain injury markers dynamics during cardiopulmonary bypass[J].Anesteziol Reanimatol,2015,60(1):33-38.
[7]Bronicki RA,Hall M.Cardiopulmonary Bypass-Induced Inflammatory Response:Pathophysiology and Treatment[J].Pediatr Crit Care Med,2016,17(8 Suppl 1):S272-S278.
[8]岳强,宋心南,林高翔.三七总皂苷对体外循环致脑损伤氧化应激的影响及机制探讨[J].华夏医学,2015,28(6):25-28.
[9]Xu HY,Rong XS,Wang DP,et al.Effect of urinary trypsin inhibitor on inflammatory cytokines and organ function in patients with cardiopulmonary bypass[J].Eur Rev Med Pharmacol Sci,2017,21(9):2220-2225.
[10]于志伟,姚晓伟,潘军强.丹红注射液对兔主动脉动脉粥样硬化斑块内脂联素表达的影响[J].陕西中医,2016,37(10):1436-1437.
[11]朱付平,周钰龙,李晓军,等.桃红四物液对肢体缺血再灌注损伤大鼠血清SOD与MDA的影响[J].中医药导报,2015,11(21):17-19.
[12]胡蓉,林高翔.体外循环致脑损伤的炎性介质机制研究进展[J].医药前沿,2014,20(34):350-351.