标题：环磷酰苷葡胺预处理对冠状动脉旁路移植术患者的心肌保护作用

      作者：霍毅中 1，褚燕 2，李瑞冰 1，张云涛 1，郭立新 1，刘林力 3，付长江 1，
    贺焱 1，宋计平 1，王继宏 1，张俊彪 1，张倩 1，张婷婷 1，卫瑞芳 1
(1.邢台市第三医院心脏外科，河北 邢台 054000；
2.邢台医学高等专科学校，河北 邢台 054000；
3.河北医科大学第二医院心脏外科，河北 石家庄 050000)

      卷次： 2016年27卷13期

      【摘要】 目的 评价环磷腺苷葡胺(MAC)预处理对冠状动脉旁路移植术患者的心肌保护作用。方法 选取
2013年 12月至 2015年 6月邢台市第三医院心外科择期行冠状动脉旁路移植术的患者按随机数表法随机分为对
照组(n=46)和MAC预处理组(n=50)。在麻醉诱导成功后从颈内静脉以 0.02 mg/(kg· min)输注 1次环磷腺苷葡胺
(1.0 mg/kg)，而对照组则仅给予等量生理盐水。分别于术后30 min、6 h、12 h、24 h、48 h、72 h采静脉血，即刻检测两
组患者的磷酸肌酸激酶同工酶(CK-MB)和心肌钙蛋白(cTNI)水平。结果 所有患者均成功接受冠状动脉旁路移植
术。(1) CK-MB：对照组与预处理组术后 6 h [(32.62±9.70) vs (26.45±7.84)]和 24 h [(25.80±10.41) vs (21.13±6.70)]
比较，差异均有统计意义 (P<0.05)；(2) cTNI：对照组与预处理组术后 6 h [(32.62±9.70) vs (26.45±7.84)]、24 h
[(25.80±10.41) vs (21.13±6.70)]、48 h [(19.03±7.91) vs (16.32±6.88)和72 h [(15.91±6.52) vs (14.64±4.06)]比较，差异均
有统计意义(P<0.05)。结论 在冠状动脉旁路移植术中，环磷酰苷葡胺预处理可以减轻心肌损伤。

      【关键词】 冠状动脉旁路移植术；冠状动脉粥样硬化性心脏病；环磷腺苷葡胺；心肌保护

      【中图分类号】 R654.2 【文献标识码】 A 【文章编号】 1003—6350（2016）13—2082—03


Myocardial protective effect of meglumine adenosine cyclophosphate pretreatment on patients undergoing
coronary artery bypass grafting surgery.
HUO Yi-zhong 1, CHU Yan 2, LI Rui-bing 1, ZHANG Yun-tao 1, GUO Li-xin 1,
LIU Lin-li 3, FU Chang-jiang 1, HE Yan 1, SONG Ji-ping 1, WANG Ji-hong 1, ZHANG Jun-biao 1, ZHANG Qian 1, ZHANG
Ting-ting 1, WEI Rui-fang 1. 1. Department of Cardiac Surgery, Xingtai Third Hospital, Xingtai 054000, Hebei, CHINA;
2. Xingtai Medical College, Xingtai 054000, Heibei, CHINA; 3. Department of Cardiac Surgery, the Second Hospital of Hebei
Medical University, Shijiazhuang 050000, Hebei, CHINA

【Abstract】 Objective To evaluate the myocardial protective effect of meglumine adenosine cyclophosphate
(MAC) pretreatment on patients undergoing coronary artery bypass grafting surgery . Methods A total of 96 adult pa-
tients, who underwent coronary artery bypass grafting surgery in Department of Cardiac Surgery of Xingtai Third Hospi-
tal from December 2013 to June 2015, were randomized to MAC group (n=50) and control group (n=46). After induc-
tion of anesthesia, the internal jugular vein infusion of 0.02 mg/(kg· min) MAC for one time was performed (1.0 mg/kg),
while the control group only received physiological saline. Venous blood samples were collected 30 minutes, 6 h, 24 h,
48 h, 72 h after surgery, and creatine kinase-MB (CK-MB), cardiac troponin-I (cTnI) of myocardial enzymes were mea-
sured. Results Coronary artery bypass graft surgery was performed successfully in all patients. (1) CK-MB: Compared
with the control group, CK-MB of the pretreatment group was significantly lower 6 h [(32.62±9.70) vs (26.45±7.84), P<
0.05] and 24 h [(25.80±10.41) vs (21.13±6.70) , P<0.05] after surgery. (2) cTnI: Compared with the control group, cTnI
of the pretreatment group was significantly lower 6 h [(32.62±9.70) vs (26.45±7.84), P<0.05], 24 h [(25.80±10.41) vs
(21.13±6.70), P<0.05], 48 h [(19.03±7.91) vs (16.32±6.88) , P<0.05], 72 h [(15.91±6.52) vs (14.64±4.06) , P<0.05] after
surgery. Conclusion MAC pretreatment on patients undergoing coronary artery bypass grafting surgery can relieve
myocardial injury.

      【Key words】 Coronary artery bypass grafting; Coronary atherosclerotic heart disease; Meglumine adenosine cy-
clophosphate (MAC); Myocardial protection
·论 著·
6350.2016.13.006