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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:

34

期数:

2017年8

页码:

697-699

栏目:

临床研究

出版日期:

2017-08-05

文章信息/Info

Title:

Effect of penehyclidine hydrochloride on microcirculation and myocardial injury in patients underwent off-pump coronary artery bypass grafting

作者:

李　姗; 杨现会

（郑州大学第二附属医院麻醉科，河南　郑州　450014）

Author(s):

LI Shan; YANG Xian-hui

（Department of Anesthesiology，the Second Affiliated Hospital of Zhengzhou University，Zhengzhou 450014，Henan Province，China）

关键词:

盐酸戊乙奎醚; 非体外循环冠状动脉搭桥术; 微循环

Keywords:

penehyclidine hydrochloride; off-pumb coronary artery bypass grafting; microcirculation

分类号:

R654.2

DOI:

10.7683/xxyxyxb.2017.08.009

文献标志码:

A

摘要:

目的　探讨盐酸戊乙奎醚对非体外循环冠状动脉搭桥术（OPCABG）患者微循环及心肌损伤的影响。方法　选择2015年10月至2016年12月择期于郑州大学第二附属医院全身麻醉下行OPCABG的患者40例，随机分为盐酸戊乙奎醚组和对照组，每组20例。盐酸戊乙奎醚组患者于右侧颈内静脉穿刺置管术后注入盐酸戊乙奎醚0.05 mg·kg^-1，对照组患者予以等容量生理盐水，分别于麻醉诱导后（T₀）、注入盐酸戊乙奎醚后血管吻合完成即刻（T₁）、术后2 h（T₂）、术后24 h（T₃）时采集动脉血检测乳酸（LA）水平，采集中心静脉血检测静脉血氧饱和度（SvO₂）及心肌肌钙蛋白I（cTnI）水平，并记录相应时间点的尿量。结果　T₀时2组患者血清LA、cTnI水平及SvO₂、尿量比较差异均无统计学意义（P>0.05）。对照组患者T₁、T₂、T₃时血清LA、cTnI水平及尿量显著高于T₀时（P<0.05），SvO₂显著低于T₀时（P<0.05）。盐酸戊乙奎醚组患者T₁、T₂、T₃时血清LA、cTnI水平及尿量显著高于T₀时（P<0.05），T₂、T₃时SvO₂显著高于T₀时（P<0.05）。T₁、T₂、T₃时盐酸戊乙奎醚组患者血清LA、cTnI水平显著低于对照组（P<0.05），SvO₂、尿量显著高于对照组（P<0.05）。结论　盐酸戊乙奎醚具有改善OPCABG患者微循环、保护心肌的作用。

Abstract:

Objective　To investigate the effect of penehyclidine hydrochloride on microcirculation and myocardial injury in patients underwent off-pump coronary artery bypass grafting （OPCABG）.Methods　Forty patients underwent OPCABG under general anesthesia were selected from October 2015 to December 2016 in the Second Affiliated Hospital of Zhengzhou University.The patients were randomly divided into penehyclidine hydrochloride group and control group，20 cases in each group.The patients in the penehyclidine hydrochloride group were injected with penehyclidine hydrochloride 0.05 mg·kg^-1 after right internal jugular vein puncture，and the patients in the control group were given equal capacity saline.The level of lactic acid （LA） in the arterial blood，the venous oxygen saturation （SvO₂） and cardiac troponin I （cTnI） level in the central venous blood were detected，and the urine volume was recorded at the time points of after the anesthesia induction （T₀），the vascular anastomosis completion after the injection of penehyclidine hydrochloride（T₁），two hours （T₂） and 24 hours （T₃） after operation.Results　There was no significant difference in serum LA and cTnI levels，SvO₂，urine volume between the two groups at T₀（P>0.05）.The serum LA and cTnI levels and urine volume at T₁,T₂ and T₃ were significantly higher than those at T₀ （P<0.05），and the SvO₂ at T₁,T₂ and T₃ was significantly lower than that at T₀ in the control group（P<0.05）.The serum LA and cTnI levels and urine volume at T₁,T₂ and T₃ were significantly higher than those at T₀ （P<0.05），and the SvO₂ at T₂ and T₃ was significantly higher than that at T₀ in the penehyclidine hydrochloride group （P<0.05）.The serum LA and cTnI levels in the penehyclidine hydrochloride group were significantly lower than those in the control group at T₁,T₂ and T₃（P<0.05），the SvO₂ and urine volume in the penehyclidine hydrochloride group were significantly higher than those in the control group at T₁,T₂ and T₃（P<0.05）.Conclusion　Penehyclidine hydrochloride can improve microcirculation and protect myocardium in patients underwent OPCABG.

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更新日期/Last Update: 2017-08-05