Antioxidant therapy with Salvia miltiorrhiza decreases plasma endothelin-1 and thromboxane B2 after cardiopulmonary bypass in patients with congenital heart disease
Antioxidant therapy with Salvia miltiorrhiza decreases plasma endothelin-1 and thromboxane B2 after cardiopulmonary bypass in patients with congenital heart disease
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DOI：
10.1016/s0022-5223(03)00970-x
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发表时间：
2003-11-01
影响因子：
6
通讯作者：
Yu, JF
中科院分区：
文献类型：
--
作者：
Xia, ZY;Gu, JZ;Yu, JF
目的：先天性心脏缺损患儿体外循环后内皮源性血管收缩剂内皮素-1水平升高。本研究确定丹参注射液（一种含酚类化合物的草药提取物）抗氧化治疗是否能阻止术后内皮素-1的增加。研究了内皮素-1与术后内皮源性前列环素（前列腺素12）、血栓素A2之间的关系。方法：将20例先天性心脏缺陷合并肺动脉高压患儿随机分为A组（安慰剂对照，n = 10）和B组（麻醉诱导后和复温时分别静脉注射丹参200 mg/kg， n = 10）。术前（T-0）、术后10 （T-1）、术后30分钟（T-2）、主动脉瓣去主动脉术后10 （T-3）、术后30分钟（T-4）、术后30分钟（T-5）、术后24小时（T-6）采集中心静脉血。血浆脂质过氧化产物丙二醛、心肌特异性肌酸激酶mb活性、血栓素132和6-酮前列腺素f -1 α。测定血栓素A2和前列腺素12的稳定代谢产物。结果：A组丙二醛在T-1时显著升高，此后仍显著高于B组（P < 0.05）。B组丙二醛未随时间显著升高。T-5时，B组血浆肌酸激酶- mb、血栓素B2、内皮素-1均低于A组（P < 0.05）；丙二醛与肌酸激酶- mb显著相关（r = 0.71, P = 0.0005）。在T-6时，内皮素-1与6-酮-前列腺素f -1 α /血栓素B2比值呈负相关（r = -0.64, P = 0.0025）。结论：抗氧化治疗可减轻心肌损伤，减轻术后血管活性介质失衡。
Objective: The endothelium-derived vasoconstrictor endothelin-1 is increased after cardiopulmonary bypass in children with congenital heart defects. This study determines whether antioxidant therapy with Salvia miltiorrhiza injection, an herb extract containing phenolic compounds, prevents the postoperative increase of endothelin-1. The relationship between endothelin-1 and the endothelium-derived prostacyclin (prostaglandin 12) and thromboxane A2 postoperatively is also investigated.Methods: Twenty children with congenital heart defects and pulmonary hypertension were randomly assigned to group A (placebo control, n = 10) or B (200 mg/kg Salvia miltiorrhiza intravenously after anesthesia induction and at the time of rewarming, respectively; n = 10) before cardiac surgery. Central venous blood samples were taken before operation (T-0), 10 (T-1) and 30 minutes (T-2) after starting cardiopulmonary bypass, 10 (T-3) and 30 minutes (T-4) after aortic declamping, and 30 minutes (T-5) and 24 hours (T-6) after termination of cardiopulmonary bypass., Plasma lipid peroxidation product malondialdehyde, myocardial specific creatine kinase-MB activity, thromboxane 132, and 6-keto-prostaglandin F-1alpha. (stable metabolites of thromboxane A2 and prostaglandin 12) were measured.Results: Malondialdehyde increased significantly at T-1 in group A and remained significantly higher than in group B thereafter (P < .05). Malondialdehyde in group B did not significantly increase over time. At T-5, plasma creatine kinase-MB, thromboxane B2, and endothelin-1 in group B were lower than in group A (P < .05); malondialdehyde correlated significantly with creatine kinase-MB (r = 0.71, P = .0005). At T-6, endothelin-1 negatively correlated with the 6-keto-prostaglandin F-1alpha/thromboxane B2 ratio (r = -0.64, P = .0025).Conclusion: Antioxidant therapy reduces myocardial damage and attenuates postoperative vasoactive mediator imbalance.