Abstract:

Objective To investigate the myocardium protection of  cardiomyopeptide for injection against ischemia-reperfusion injury  during open heart surgery withcardiopulmonary bypass(CPB).Methods Thirty patients scheduled for elective cardiac valvular replacement were divided into two groups.In treatment group (n=15),
 cardiomyopeptide for injection  was used during CPB;but in control group (n=15),no cardiomyopeptide for injection was used.Blood samples were drawn from the radial artery at the following time points: before CPB(T0);at release of aortic declamping(T1);30 min after aortic declamping(T2);12 h after aortic declamping(T3);24 h after aortic declamping(T4).The levels of creatine phosphokinase isoenzyme(CK-MB),cardiac troponin I(cTnI) in plasma  were measured.Enzyme-linked immunosorbent assays (ELISA) was used to measure the concentration of tumor necrosis factor-a (TNF-a)in plasma.Ejection fraction(EF) was measured at the 7th day after operation.Results The levels of CK-MB，cTnI,and TNF-α in plasma in two groups showed no difference before CPB(P>0.05).The levels of CK-MB and TNF-α in two groups were  significantly increased30 min after aortic declamping than  release of aortic declamping (P<0.05).The levels of CK-MB and TNF-α in plasma in treatment group were significantly lower than those in control group 30 min,12 h and 24 h after aortic declamping(P<0.05).The plasma concentrations of cTnI in two groups were  significantly increased at release of aortic declamping (P<0.05).The concentrations of cTnI in treatment group were significantly lower than those in  control group at T1,T2,T3,T4(P<0.05).EF in treatment group  was significantly higher than that in  control group at the 7th day after operation(P<0.05).Conclusion Cardiomyopeptide for injection can  protect myocardium and reduce the acute inflammatory response during CPB and improve heart function after operation.
 

Key words: cardiomyopeptide;cardiopulmonary bypass;myocardium protection;ischemia-reperfusion injury