Myocardial protective effects of recombinant human erythropoietin pretreatment on patients undergoing cardiopulmonary bypass / 重庆医学

ABSTRACT

Objective To investigate the myocardial protective effects ,mechanism and safety of recombinant human erythropoie-tin(rHuEPO) pretreatment in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) .Methods Thirty pa-tients with rheumatic heart disease undergoing valve replacement surgery were randomly divided into the observation group and the control group ,15 cases in each group .The observation group was given rHuEPO 300IU/kg by hypodermic injection on preoperative 2 d ,once daily for twice .The control group was given the same dose of normal saline .The blood routine was performed before sur-geryandonpostoperative7d.Thelevelsofcreatinekinaseisoenzyme(CK-MB)andtroponinT(cTnT)weredetectedbeforeopera-tion ,at 6 ,24 ,72 h after the aorta opening (T0 ,T6 ,T24 ,T72 ) .At the end of CPB ,myocardial biopsy was conducted for detecting the myocardial apoptosis index (AI) .The CPB time ,aortic cross clamp(ACC) time ,postoperative ICU stay ,blood transfusion and post-operative complications were recorded .Results The level of postoperative CK-MB and cTnT in the two groups were significantly increased after the aorta opening ,which at T6 was highest ,followed by a downward trend .The levels of CK-MB and cTnT at vari-ous time points in the observation group were significantly lower than those in the control group .The main effect of rHuEPO pre-treatment had statistical difference between the two groups (P= 0 .01) .Myocardial AI in the observation group was significantly lower than that in the control group ,the difference showing statistical significance (P<0 .01) .The observation group had no risk leading to obviously increase postoperative Hb ,Hct values and thromboembolism ,but the postoperative blood transfusion amount was reduced .Conclusion rHuEPO pretreatment has the protective effect on myocardium in the patients undergoing cardiac surgery under CPB ,which can reduce myocardial apoptosis and has safe reliability .