Effects of Extracorporeal Circulation Prefilled GSH on Myocardial Injury,Lung Injury and Oxidative Stress Response in Patients Undergoing Cardiac Valve Replacement
Objective:To investigate the effect of extracorporeal circulation prefilled glutathione(GSH)in patients undergoing heart valve replacement.Method:A total of 65 patients who received heart valve replacement in Xiamen Fifth Hospital from January 2020 to January 2022 were selected as the study objects.They were divided into control group(n=32)and observation group(n=33)according to random number table method.The control group was added 1 200 mg Sodium Chloride Injection into the extracorporeal circulation priming fluid,and the observation group was added 1 200 mg GSH into the extracorporeal circulation priming fluid.Perioperative indexes,myocardial injury indexes,lung injury indexes and oxidative stress indexes were compared between the two groups.Result:The intraoperative conversion time and ventilator use time in the observation group were shorter than those in the control group,and the total Dopamine use was less than that in the control group,the differences were statistically significant(P<0.05).At 2 h(T2),12 h(T3)and 24 h(T4)after aortic opening,the levels of creatine kinase isoenzyme,lactate dehydrogenase,troponin I and myoglobin in two groups were higher than those before surgery(T1),but those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).At T4,the oxygenation index in two groups was lower than that in T1,and the respiratory index and dynamic lung compliance were higher than that in T1,but the oxygenation index and dynamic lung compliance in observation group were higher than those in control group,and the respiratory index in observation group was lower than that in the control group,the differences were statistically significant(P<0.05).At T4,the levels of malondialdehyde and glutathione peroxidase in two groups were higher than that in T1,and the levels of superoxide dismutase were lower than that in T1,and the levels of malondialdehyde and glutathione peroxidase in observation group were higher than those in control group,and the levels of superoxide dismutase in observation group was lower than those in control group,the differences were statistically significant(P<0.05).Conclusion:The pre-filling of GSH during extracorporeal circulation can shorten the duration of intraoperative flow and ventilator use in patients with heart valve replacement,reduce the use of Dopamine after surgery,reduce myocardial injury and lung injury,and contribute to the alleviation of oxidative stress response.
万方数据
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