Cardioprotective Effects of Electroacupuncture Pretreatment on Patients Undergoing Heart Valve Replacement Surgery: A Randomized Controlled Trial
Cardioprotective Effects of Electroacupuncture Pretreatment on Patients Undergoing Heart Valve Replacement Surgery: A Randomized Controlled Trial
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DOI：
10.1016/j.athoracsur.2009.12.003
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发表时间：
2010-03-01
影响因子：
4.6
通讯作者：
Xiong, Lize
中科院分区：
文献类型：
--
作者：
Yang, Lifang;Yang, Jian;Xiong, Lize
背景体外循环术后心脏缺血再灌注损伤是心内直视手术患者术后发病率和死亡率的重要因素。本研究旨在探讨电针预处理对心脏瓣膜置换术患者心肌损伤的保护作用。将60例获得性心脏瓣膜病患者随机分为电针预处理组和对照组。电针组于术前电针双侧内关、列缺、云门穴，每天30 min，连续5 d。比较两组的血流动力学数据、机械通气时间、重症监护室中正性肌力药物的使用、血清心肌肌钙蛋白I浓度、发病率和死亡率。本试验已在ClinicalTrials注册。gov，编号NCT 00732459。电针组再灌注后6、12、24小时血清心肌肌钙蛋白I水平明显降低与对照组（7.89 +/-0.74，8.34 +/- 1.08和7.57 +/- 0.89，p < 0.05）相比，电针预处理显著降低了主动脉阻断解除后6小时、12小时和24小时血清肌钙蛋白I的总释放。同时，电针预处理还能降低患者到达重症监护室后12 h、24 h和48 h的正性肌力评分，缩短重症监护室停留时间（p < 0.05）。本研究表明，电针预处理可以减轻心脏瓣膜置换术后心脏缺血再灌注损伤。这种简单方便的治疗方法有可能在临床上用于减少心脏瓣膜置换术患者的心肌损伤。(Ann Thorac Surg 2010; 89：781-6）（C）2010年，胸外科医师协会
Background. Cardiac ischemia-reperfusion injury after cardiopulmonary bypass contributes to postoperative morbidity and mortality in patients with open-heart surgery. This randomized controlled trial was designed to address the protective effects of electroacupuncture (EA) pretreatment on myocardial injury in patients undergoing heart valve replacement surgery.Methods. Sixty patients with acquired heart valve disease were randomly allocated to the EA pretreatment group or the control group. Patients in the EA group received EA stimulus at bilateral Neiguan (PC 6), Lieque (LU 7), and Yunmen (LU 2) for 30 minutes each day for five consecutive days before surgery. Hemodynamic data, mechanical ventilation time, inotropic drug use in the intensive care unit, serum cardiac troponin I concentrations, morbidities, and mortalities were compared between the two groups. This trial is registered with ClinicalTrials. gov, number NCT00732459.Results. At 6 hours, 12 hours, and 24 hours after reperfusion, levels of serum cardiac troponin I were significantly decreased in the EA group (5.74 +/- 0.67, 6.22 +/- 0.66, and 5.21 +/- 0.58) compared with that in the control group (7.89 +/- 0.74, 8.34 +/- 1.08, and 7.57 +/- 0.89, p < 0.05). The EA pretreatment significantly reduced overall serum troponin I release at 6 hours, 12 hours, and 24 hours after aortic cross-clamp removal. Meanwhile, EA pretreatment also reduced the inotrope score at 12 hours, 24 hours, and 48 hours after the intensive care unit arrival and shortened intensive care unit stay time (p < 0.05).Conclusions. The present study demonstrated that EA pretreatment may alleviate cardiac ischemia-reperfusion injury in adult patients undergoing heart valve replacements. This simple and convenient treatment has the potential to be used in the clinic for reducing myocardial injury in patients with heart valve replacement surgery. (Ann Thorac Surg 2010; 89: 781-6) (C) 2010 by The Society of Thoracic Surgeons