摘要
目的 :研究卡托普利在开心手术中对缺血心肌的延迟期保护效应。方法 :2 0例先天性心脏病室间隔缺损患者被随机分配为卡托普利组及对照组 (n =10 )。卡托普利组于术前 48h一次口服卡托普利每公斤体重 1mg。检测患者手术前后的血清肌酸磷酸肌酶MB(CK MB)活性变化及缺血前后右心房肌的三磷酸腺苷 (ATP)含量变化 ,用WesternBlotting方法检测两组各 4例患者的心肌热休克蛋白 70 (HSP70 )表达情况。结果 :①两组患者的CK MB活性在术后 6h及 12h均明显增高 ,但两组在统计学上无显著差别 (P >0 .0 5 )。②卡托普利组缺血时ATP消耗较对照组低 ,分别为 (1 40± 0 5 6 ) μmol·g-1和 (2 0 6± 0 72 ) μmol·g-1(P <0 .0 5 )。③两组患者心肌均有HSP70表达 ,卡托普利组表达较对照组明显增加。结论 :心脏直视手术前 48h口服卡托普利 (mg·kg-1)有利于缺血心肌的ATP保存 ,其保护作用可能与HSP70的表达增加有关。
Objective: To investigate whether there is delayed cardioprotection of captopril pretreatment in open heart surgery. Methods: Twenty patients with ventricular septal defect (VSD) undergone open heart surgery were randomly divided into captopril group (CAP group) and control group. In the CAP group, patients were pretreated with captopril (1?mg·kg -1 , oral) at 48 hours before operation, No special treatment was given at the same time in the control group. Release of creatine phosphokinase MB (CK MB) and myocardial adenosine triphosphate (ATP) content was studied. Heat shock protein 70 (HSP70) in myocardum was examined using Western blotting analysis. Results: No statistically significant difference was found in release of CK MB between control group and CAP group. ATP depletion was (1.40±0.56)?μmol·g -1 , (2.06±0.72)?μmol·g -1 in CAP group and control group respectively (P<0.05). Western blotting analysis showed that both group had HSP70 expression. In CAP group, HSP70 expression was higher than that in control group. Conclusion: The results suggest that captopril pretreatment 48 hours before operation could reduce ATP depletion in pediatric patients of VSD during open heart surgery, and HSP70 might be involved in the delayed cardioprotection induced by captopril. [
出处
《湖南医科大学学报》
CSCD
北大核心
2001年第1期73-76,共4页
Bulletin of Hunan Medical University
