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The effect of sevoflurane preconditioning combined with postconditioning on serum concentration of cTnⅠ,Mb,CK -MB and MDA in patients undergoing cardiac valve replacement with cardiopulmonary bypass
Author(s): ZHANG Yong, GAO Tianqin, JING Guangjian, ZHANG Ruyi, WANG Yaoqi
Pages: 179-
181
Year: 2016
Issue:
3
Journal: Qilu Pharmaceutical Affairs
Keyword: Sevoflurane; Cardiopulmonary bypass; Cardiac troponin Ⅰ; Myohemoglobin; Malondialdehyde;
Abstract: Objective To investigate the effect of sevoflurane preconditioning combined with postconditioning on serum concentration of cTnⅠ,Mb,CK -MB and MDA in patients undergoing cardiac valve replacement with cardiopulmonary by-pass.Methods Fifty ASA physical status Ⅱor Ⅲ patients(NYHA Ⅱor Ⅲ),aged 37 ~60 years,weighing 44 ~70 kg,with rheumatic heart disease undergoing cardiac valve replacement under CPB,were enrolled and divided randomly into sevoflu-rane preconditioning combined with postconditioning group(group S)and control group(group C).In group S,1.5 MAC sevoflurane was inhaled for 10 min via the anesthesia machine before the start of CPB,and infused for 10 min via the extra-corporeal circulation machines starting from the time point immediately after aortic unclamping.Before anesthesia induction, 15 min,8 h,and 24 h after aortic unelamping(T1 -4 ),blood samples were collected from the central vein for determination of the levels of cTnⅠ,Mb,CK -MB and MDA in plasma.The restoration of spontaneous heart beat,reperfusion arrhythmia scores were recorded.Results Compared with T1 ,the concentration of cTnⅠ,Mb,CK -MB and MDA were increased at T2 ~T4 in both group(P <0.05).Compared with group C,the concentration of cTnⅠ,Mb,CK -MB and MDA were de-creased at T2 ~T4 ,the rate of restoration of spontaneous heat beat was increased,reperfusion arrhythmia scores were de-creased in group S(P <0.05).Conclusion Sevoflurane preconditioning combined with postconditioning can remarkably decrease the concentration of cTnⅠ,Mb,CK -MB and MDA,and provide myocardial protection in patients with rheumatoid heart disease during valve replacement surgery with CPB,probablely by reducing myocardial oxidative stress injury.
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