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《The Journal of Clinical Anesthesiology》 2013-01
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Effects of co-administration with edaravone and fructose-1,6-diphosphate on myocardial protection in patients undergoing cardiac valve replacement

SHU Ya,HAN Bin,ZHAO Jun-ying,HE Ai-ping,YU Jin-gui,QI Feng.Department of Anesthesiology, Affiliated Hospital of Xi'an Medical University,Xi'an,710077, China  
Objective To investigate the myocardial protection effects of radical scavenger edaravone(MCI-186) combined with fructose-1,6-diphosphate(FDP) in patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB). Methods Forty patients with rheumatic heart disease undergoing mitral,aortic,mitral or aortic valve replacement were randomly divided into four groups: control group (group A),group MCI-186 g(group B),group FDP(group C),MCI-186 and FDP combination group(group D, n =10 each). The same volume of saline solution was infused intravenously in group A. Group B received edaravone injection 0.5 mg/kg in cardioplegia solution. 200 mg/kg FDP was intravenously infused before aorta-clamping in group C. Edaravone 0.5 mg/kg was mixed with CPB priming fluid and FDP 200 mg/kg was given intravenously 15 min before aortic cross clamp in group D. Plasma activity of superoxide dismulase (SOD) and levels of malondialdehyde (MDA), creatinekinase-MB and cardiac troponin I were measured before skin incision(T1 ),before aortic-clamping(T2 ),at 2 h and 6 h after CPB and 24 h postoperative (T3 -T5 ). Meanwhile, the clinical effectiveness of each group was observed. Results Compared with T1, SOD activity decreased significantly at T2 -T4 in group A, while the levels of serum MDA, CK-MB at T3 -T5 and cTnI at T2 -T5 increased significantly in all groups( P 0.05). Compared with group A, SOD activity at T2 -T4 increased significantly,while levels of serum MDA and CK-MB at T3 -T5 decreased in other groups,the levels of cTnI in group B,C,D at T3 and in group B,D at T4 were obviously decreased. ( P 0.05 or P 0.01).The concentration of cTnI in group B and C was obviously higher than that in group D at T3 ,T4 ( P 0.05).The consumption of dopa mine and drainage quantity within 24 h after surgery were much more in group A than those in group D( P 0.05). Conclusion Edaravone and FDP has notable protective effect on myocardial ischemia and reperfusion injury, especially when using combined.
【CateGory Index】: R654.2
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