Erythropoietin pretreatment for myocardial protection in perioperative period of infant congenital heart disease operation / 中国小儿急救医学

ABSTRACT

Objective To study the effect of erythropoietin( EPO) pretreatment on myocardial pro-tection in perioperative period of infant congenital heart disease operation and explore its underlying mecha-nism. Methods All the 80 patients who were suffered from non-cyanotic congenital heart disease undergone cardiopulmonary bypass in open heart operation were selected from Shengjing Hospital of China Medical Uni-versity cardiac surgery ward from April 2014 to January 2017. The patients were randomly divided into A,B, C three groups according to blocked randomization method. Group A patients were treated with subcutaneous injection of EPO 150 IU/kg 12 hours before operation,group B patients were treated with subcutaneous injec-tion of EPO 300 IU/kg 12 hours before operation,patients in group C( control group) had no treatment. All patients were detected myocardial zymetology after admission to hospital as well as 24 h,48 h,72 h after oper-ation. HSP70,ERK1/2 mRNA and protein expression in right auricle were detected by qRT-PCR and Western blot method,respectively. Results At each time point after operation,myocardial zymetology were signifi-cantly lower in group A and B compared with group C,the index of myocardial zymetology in group A were lower than that in group B(P<0. 05). The expressions of HSP70,ERK1/2 mRNA and protein were signifi-cantly up-regulated in group A and B compared to the control group(P<0. 05). The expressions of HSP70, ERK1/2 mRNA and protein in group A were significantly higher than those in group B ( P < 0. 05 ) . Conclusion EPO pretreatment has a positive effect on the myocardial protection during cardiopulmonary bypass. EPO may act a role of endogenous myocardial protection through up-regulation of the expressions of HSP70 and ERK1/2. The dosage of 150 IU/kg EPO is more significant on the effect of myocardial protection.