本文選題：二尖瓣置換術(shù) + 左西孟旦　； 參考：《延邊大學(xué)》2014年碩士論文

【摘要】：目的：探左西孟旦(Levosimendan Injection, LEV)在體外循環(huán)下二尖瓣置換術(shù)中心肌缺血-再灌注損傷的保護(hù)作用。 方法：選取延邊大學(xué)附屬醫(yī)院心血管外科2011年11月至2014年3月風(fēng)濕性心臟瓣膜病患者28例,隨機(jī)分為對照組(n=14))和LEV組(n=14),對照組患者術(shù)前術(shù)中給予常規(guī)心肌營養(yǎng),左西孟旦組患者在麻醉誘導(dǎo)前左西孟旦注射液0.2ug/kg/min持續(xù)24h靜脈給藥,分別于術(shù)前(T1)、術(shù)畢(T2)、術(shù)后24h(T3)、術(shù)后7d(T4)抽取患者靜脈血,檢測血漿乳酸脫氫酶(lactate dehydrogenase, LDH),肌酸激酶(Creatine Kinase, CK),肌酸激酶同工酶(Creatine Kinase-MB, CK-MB),心肌肌鈣蛋白I (Cardiac Troponin I, cTnI),并記錄患者術(shù)前及術(shù)后7d左室射血分?jǐn)?shù)(left ventricular ejection fraction, LVEF)。 結(jié)果： 與對照組相比,給藥組T2、T3、T4血漿LDH, cTnI濃度明顯低于T1(P0.01,P0.05),T2、T3血漿CK、CK-MB濃度均明顯低于T1(P0.01,P0.05),T4無明顯統(tǒng)計(jì)學(xué)差異(P0.05)。對照組術(shù)前與術(shù)后相比LVEF無明顯差異(P0.05),給藥組LVEF較術(shù)前升高(P0.05)。 結(jié)論：1.左西孟旦注射液對二尖瓣置換術(shù)后患者具有降低心肌酶學(xué)指標(biāo)和cTnI水平,有效地提高左室射血分?jǐn)?shù)作用。 2.左西孟旦注射液可減輕心臟瓣膜置換術(shù)中的心肌缺血-再灌注損傷,對心肌具有保護(hù)性作用。
[Abstract]:Aim: to investigate the protective effect of Levosimendan injection (Levo simendan injection) on myocardial ischemia-reperfusion injury during mitral valve replacement under cardiopulmonary bypass (CPB). Methods: from November 2011 to March 2014, 28 patients with rheumatic heart valve disease were randomly divided into two groups: control group (n = 14) and LEV group (n = 14). The patients in control group were given routine myocardial nutrition before operation. The patients in the levosimendan group received 0.2ug/kg/min for 24 hours before anesthesia induction. Venous blood was extracted from the patients with T1, T2, T3, and T4 at 24 hours after operation, 7 days after operation, respectively, before anesthesia induction, the patients were given intravenous administration of levsimendan injection for 24 hours before anesthesia induction, and the patients were given intravenous administration of levsimendan injection for 24 hours before anesthesia induction. Plasma lactate dehydrogenase (LDH), creatine kinase (CK), creatine kinase isoenzyme (CK-MBP), cardiac troponin I cardiac Troponin I (cTnI), left ventricular ejection fraction (LVEF) were measured before and 7 days after operation. Results: Compared with the control group, the plasma LDHs and cTnI concentrations in the administration group were significantly lower than those in the T1P0.01P0.05T2T3 and T1P0.01P0.05T4 groups. There was no significant difference between the two groups (P 0.05). There was no significant difference in LVEF before and after operation in the control group (P 0.05). The LVEF in the administration group was significantly higher than that in the preoperative group (P 0.05). Conclusion 1. Levosimendan injection can decrease myocardial enzyme index and cTnI level and increase left ventricular ejection fraction (LVEF) after mitral valve replacement. 2. Levosimendan injection can reduce myocardial ischemia-reperfusion injury in cardiac valve replacement and has protective effect on myocardium.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R654.2

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