环磷酰苷葡胺预处理与缺血后处理对cabg的心肌保护研究

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1、授予单位代码10089学号或中请号13099HebeiMedicalUniversity硕士学位论文在职科学学位环磷酰苷葡胺预处理与缺血后处理对CABG的心肌保护研究学位申请人：霍毅中导师：刘林力教授专业：外科学二级学院：第二医院2015年3月河北医科大学学位论文使用授权及知识产权归属承诺本学位论文在导师（或指导小组）的指导下，由本人独立完成。本学位论文研究所获得的研究成果，其知识产权归河北医科大学所有。河北医科大学有权对本学位论文进行交流、公开和使用。凡发表与学位论文主要内容相关的论文，第一署名为单位河北医科大学，试验材料

2、、原始数据、申报的专利等知识产权均归河北医科大学所有。否则，承担相应法律责任。研究生签名:导师签章二级学院领导盖章:从「年r月々日河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究工作及取得的研究成果，除了文中特别加以标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究成果，指导教师对此进行了审定。本论文由本人独立撰写，文责自负。研究生签名：中导师签章月4目录中文摘要······································································

3、········1英文摘要··············································································3英文缩写··············································································6研究论文环磷酰苷葡胺预处理与缺血后处理对CABG的心肌保护研究前言·························································

4、·····················7材料与方法·····································································7结果··············································································9附图·············································································11附表····

5、·········································································22讨论·············································································24结论·············································································27参考文献························

6、···············································27综述药物预处理在心脏外科手术治疗中的心肌保护作用··············29致谢···················································································39个人简历·············································································40中文摘要环磷

7、酰苷葡胺预处理与缺血后处理对CABG的心肌保护研究摘要CK-MB是肌酸激酶(CK)的同工酶，主要存在于心肌中，在心脏手术后，血液中CK-MB将会增高。cTnI是一种心肌收缩调节蛋白，在心脏术后也会增高，但其敏感性及特异性明显高于肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)。cTNI、CK-MB将作为评价心肌损伤指标。环磷酸腺苷(cAMP)是细胞内参与生物学功能的重要物质，重要的第二信使，可以提高心肌抗损伤的能力。环磷腺苷葡胺是cAMP重要的衍生物之一，其作用机制可能是环磷腺苷葡胺借助葡甲胺的影响，进入心肌细胞内，降解为腺苷

8、和磷酸，同时葡甲胺抑制生物酶对cAMP的分解作用，达到心肌保护作用。29年前，murry等人首次表明，短暂的不致命的缺血和再灌注之前持续缺血减少心肌梗死面积，并称为“缺血性预处理”。12年前zhao等对犬心肌进行3次短暂I/R(I-30s/R-30s×3)处理，发现可减少心肌梗死面积，并有