左西孟旦在重症瓣膜性心脏病外科手术心肌缺血预处理中的应用

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Abstract Objective To study the protective effect of Levosimendan on ischemic preconditioning in patients with severe valvular heart disease, in order to explore the optimal myocardial protection strategy to reduce ischemia-reperfusion injury in cardiac surgery. Methods From January to May in 2017, 40 patients with severe valvular heart disease from Department of Cardiac Surgery in Dongguan Kanghua Hospital were retrospectively andlyzed, and they were divided into two groups according to treatment: Levosimendan ischemic preconditioning group (group A, 20 cases) and untreated Levosimendan group (group B, 20 cases). During the onset of thoracotomy and 10 minutes before the occlusion of the aorta, the total length was about 30 minutes, the peripheral vein of group A was continuously pumped into Levosimendan at a dose of 6-12 μg/kg. the changes of myocardial enzymes (CK-MB), troponin Ⅰ (cTnⅠ) and blood lactic acid （BLA） were measured at 6, 18 h and 48 h after aortic off-clamping in the two groups. LVEF, LVSWI, CI were recorded before and 1, 3, 7 d after operation. The complications of renal injury and arrhythmia and low cardiac output were recorded. Results There were statistically significant differences of CK-MB, cTnⅠ, BLA, LVEF, CI, LVSWI levels between the two groups at different time points after aortic off-clamping (P < 0.05). The incidence of complications in group A was lower than that in group B (P < 0.05). Conclusion Myocardial ischemic preconditioning with Levosimendan in patients with severe valvular heart disease can be used to reduce the degree of myocardial ischemia and reperfusion injury and the complications of perioperative period, which can improve the treatment of patients with cardiac surgery.

Key words： Levosimendan Severe heart disease diseases Ischemic preconditioning Myocardial protection Low cardiac output syndrome Ischemia-reperfusion injury

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	PENG Xiaopeng1
	2 YANG Wencong3
	4 SHEN Guogang5 SHAN Fei1 LIN Ming1 KE Lüesen1 Huang Jinsong2▲ ZHOU chengbin2

Cite this article:

PENG Xiaopeng1,2 YANG Wencong3,4 SHEN Guogang5 SHAN Fei1 LIN Ming1 KE Lüesen1 Huang Jinsong2▲ ZHOU chengbin2. Application of Levosimendan in myocardial ischemia preconditioning in patients with severe valvular heart disease[J]. 中国医药导报, 2018, 15(8): 48-51,59.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I8/48

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