The Clinical Study Of Myocardial Protective Effect Of Reduced Glutathione In Patients With Valve Replacement

ObjectiveTo investigate the myocardial protection effect of Reduced Glutathione (GSH)in patients with valve replacement, thereby providing a new clinical management to cardiac surgery and other important organs which undergoing ischemic reperfusion injury.MethodsThirty patients with rheumatic heart disease undergoing cardiac valve replacement were randomly divided into two groups.Reduced Glutathione group (group GSH, n=15) received GSH in cardioplegia solution, and control group (group C, n=15) received cardioplegia alone. Blood samples were taken After induction of general anesthesia (T1), at 2h (T2),8h (T3),24h(T4) after deelamping aorta for determination of CK, CK-MB, LDH, Mb, hs-TNT, MDA; and before T1, at 3d (T5) after deelamping aorta for ALT, AST, Cr, BUN; and before T1, at T5, at 7d (T6) after deelamping aorta for NT-proBNP. meanwhile, the clinical effectiveness of the two groups was observed.ResultsNo severe complications and deaths in both groups.(1) The levels of CK,CK-MB,LDH,Mb,hs-TNT at T2 were higher than those at T1 in both two groups (P<0.01), those in group G were lower than those in group C(P<0.05). (2) The levels of NT-proBNP at T4 were higher than those at T1 in both two groups(P<0.01), those in group G were lower than those in group C. There were no statistical difference at T6 in two groups(P>0.05).(3) The levels of MDA in group G were lower than group C at all time points after deelamping aorta (P<0.05)(4) There were no statistical difference to the levels of ALT, AST, Cr, BUN between two groups(P>0.05).(5)The values of LVEF,SV and CI at T1 and 6d after deelamping aorta were no statistical differences in two group (P>0.05). The rate of heart spontaneous rebeating in group G were higher than those in group C.The dose of dopamine using after surgery the days of dopamine using after surgery,the time of ventilator using after surgery,the time of treatment in ICU in group G were lower than those in group C (P<0.05)Conclusion(1) Blood cardioplegia with GSH can decrease the production of MDA and the levels of CK,CK-MB,LDH,Mb,hs-TnT;(2) GSH can effectively reduce exudation of NT-proBNP after operation.(3) GSH can reduce myocardium ischemic in Patients with Valve Replacement.