| ObjectiveTo observe the protective effects of edaravone injection on myocardial ischemia-reperfusion injury in patients with cardiopulmonary bypass(CPB)during open heart surgery.MethodsThirty patients undergoing single valve replacement(including MVR and AVR)were randomly divided into two groups ,group M (n=15)received edaravone,while group C(n=15)did not receive edaravone .There is no remarkable difference between the two groups in age, body weight ,sex ratio .The patients in group M received respectively 0.25mg edaravone injection per kilogram body weigt in cold blood cardioplegic solution and priming solution ,while those in group C received the same volume of 0.9% normal saline .The methods of CPB and infusion in the two groups were the same.Blood samples were taken from patients at the following time points: (1)before CPB ( T1 ) ;(2)instantly after aorta-unclamping(T2);(3)2 hours after CPB(T3);(4)6 hours after CPB(T4);(5)12 hours after CPB(T5);(6)24 hours after CPB(T6);(7)48 hours after CPB(T7).Then the content of LDH,CK,CK-MB,MDA,SOD in plasma of all blood samples was test.In the mean time ,we observed and recorded some indexes of the two groups:the CPB time,aorta-occlusion time,supplementary circulation time,the incidence of spontaneous recovery of heart,the incidence of postoperative arrhythmias and the dose of positive inotropic medicine used in 24 hours post operation.Results1.There is no remarkable difference between the two groups in the CPB time ,the aorta-occlusion time and the supplementary circulaton time(P>0.05).2 . The incidence of spontaneous recovery of heart in group M after aorta-unclamping was 46.66% ,whereas the same index in group C was 26.67% .The difference between the two groups was very significant(P<0.01).3.The incidence of postoperative arrhythmias in group C was 53.33% ,while that in group M was 26.67%. Difference was very significant(P<0.01). 4.The dose of positive inotropic medicine used in 24 hours after operation in group M was much lower than those of group C(P<0.01):the dose of dopamine in group C was 730.36±109.23mg,and that in group M was 367.6±69.06mg;the dose of adrenaline in group C was 3.26±0.86mg ,that in group M was 0.43±0.14mg.5.The content of LDH ,CK ,CK-MB in the two groups was similar before operation (p>0.05),while those indexes of the two groups after operation were higher than before operation(P<0.05),and those indexes of group M were lower than group C at each time points(P<0.05).6. The level of MDA,SOD in the two groups was similar before operation(P>0.05),while the level of SOD decreased continuously from the time point of T2.The index of SOD increased from T6 and there was no difference between the time point of T7 and T1 in group M(P>0.05),while there was difference in group C(P<0.05). The level of MDA increased continuously after T2,while it began to decrease from T4 and reached to the normal level at T7 in the two groups .The changes of SOD and MDA in the two groups were more significant than those in group C(P<0.05).ConclusionThis study suggests that edaravone injection can offer well protective effect on myocardial ischemia-reperfusion injury during open heart surgery ,and confer a direct benefit to the patients by increasing the activity of SOD ,decreasing the production of MDA and leaking of myocardial enzyme . |
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