ABSTRACT
OBJECTIVE:
To investigate the protective effects of
insulin-
glucose on
myocardium in
patients receiving
cardiac valve replacement under
cardiopulmonary bypass.
METHODS:
Totally 120
patients receiving combined
cardiac valve replacement under
cardiopulmonary bypass were divided into
control group and
observation group according to random number table,with 60 cases in each group. All
patients were given routine operation.
Control group was given Thomas
cardioplegia and oxygenated
blood with a ratio of 14(VV)to protect
myocardium at 4 ℃. Besides that,the
observation group was additionally given
Insulin injec-tion 10 IU/L and
Glucose injection 10 g/L added into Thomas
cardioplegia at 4 ℃ to protect
myocardium. The levels of
plasma brain natriuretic peptide(BNP)and cardiac
troponinⅠ(cTnⅠ)before
anesthesia induction(T0),at the end of cardiopulmonary by-pass(T1),12 h(T2),24 h(T3),48 h(T4),and 72 h(T5)after
surgery,the rate of recovery of automatic
heartbeat after opening aor-ta,the application of vasoactive agent(
dopamine)at T1 and the occurrence of
postoperative complications were observed and com-pared between 2 groups.
RESULTS:
At T0,there was no statistical significance in the levels of
plasma BNP and cTnⅠ between 2 groups(P>0.05). The levels of
plasma BNP and cTnⅠin 2 groups at T1-5 were significantly higher than T0,with statistical signifi-cance(P0.05). The dos-age of
dopamine (at T1) and the
incidence of
complications in
observation group were statistically lower than
control group,with statistical significance(P<0.05). No severe ADR was found in 2 groups during or after
surgery.
CONCLUSIONS:
Insulin-
glucose can alleviate myocardial damage, reduce the
dosage of vasoactive agent and the
incidence of
postoperative complications in pa-tients receiving combined
cardiac valve replacement under
cardiopulmonary bypass with significant protective effect on
myocardium with good
safety.