银杏叶提取物对心脏围手术期患者血管内皮生长因子的影响

作者	单位
邓云坤	贵州省人民医院
韦方	贵州省人民医院
安邦权	贵州省人民医院
刚绍鹏	贵州省人民医院
陈静	贵州省人民医院
吴大庆	贵州省人民医院

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中文摘要:

目的探讨银杏叶提取物(金纳多)心停跳液对围手术期血浆血管内皮生长因子(VEGF)水平的影响及其临床意义。方法20例心脏手术患者采用数字表法随机均分为两组,对照组(10例)常规建立体外循环(CPB),阻断升主动脉后经主动脉根部顺灌4℃ St Thomas′停搏液(15mL/kg);银杏叶组(10例):在4℃ St Thomas′停搏液中加入金纳多(0.5mg/kg),余同对照组。麻醉诱导前后、主动脉插管后转机前、主动脉阻断0.5h、主动脉开放0.5h、术毕即刻、术后6h、术后24h分别取桡动脉血2mL采用酶联免疫吸附法(ELISA)测定VEGF浓度。结果对照组VEGF浓度在主动脉阻断0.5h开始上升,术后6h达到高峰(P<0.01);银杏叶组在主动脉阻断0.5h时已达高峰(P<0.01),主动脉开放0.5h时开始下降。结论金纳多可诱导VEGF生成,这可能是其心肌保护的机制之一。

英文摘要:

Objective To investigate the effect and clinical value of ginkgo biloba extract (Ginaton) on the plasma vascular endothelial growth factor (VEGF) in patients during peri-operative period of cardiac surgery. Methods Twenty patients scheduled to receive cardiac operation were randomly assigned to 2 groups by a digital table. For the 10 patients in the control group,the cardiopulmonary bypass (CPB) was established in routine and received cold (4℃) St Thomas′ cardioplegia perfusion (15 mL/kg) via aortic root after ascending aorta blocking,as for the 10 patients in the Ginaton group,the same was done but with 0.5 mg/kg of Ginaton added to the cardioplegia perfusion. Plasma VEGF contents were detected by ELISA at different time points,i.e. before and after anesthesia induction (T1,T2),after aorta intubation (T3),0.5 h after aorta clamping (T4),0.5 h after aorta declamping (T5),immediate after terminating the operation (T6),6 h after operation (T7),and 24 h after operation (T8). Results In the control group,VEGF level began to rise at T4 and reached the peak at T7 (P<0.01),while in the Ginaton group,it reached the peak early at T4 (P<0.01),and began to drop at T5 (P<0.01). Conclusion Ginaton could induce the production of VEGF,which may be one of the mechanisms for its myocardial protection.

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