Effects of sevoflurane post-processing on the relative index of myocardial enzyme in patients treated with heart valve replacement under cardiopulmonary bypass

Objective: To observe the effects of sevoflurane post-processing on the relative index of myocardial enzyme in patients treated with heart valve replacement under cardiopulmonary bypass(CPB).Methods: Seventy-two rheumatic heart disease patients treated with heart valve replacement under CPB were randomly divided into the sevoflurane post-processing group(group S) and control group(group C)(36 cases each group).The group S were treated with the 2% of sevoflurane by cardiopulmonary bypass into blood circulation for 15 minutes at the time of aorta opening,the group C were treated with intravenous anesthesia.The jugular venous blood was collected before anesthesia induction(T₀),after 30 min(T₁),3h(T₂) and 24h(T₃) of aorta opening,and centrifuged for 10min,the supernatant of which was stored at -20℃.The serum levels of cardiac troponin(cTnI),creatine kinase(CK),creatine kinase(CK-MB) and lactate dehydrogenase(LDH) were meaured and compared at four time points.Results: Compared at T₀,the levels of cTnI,CK,CK-MB and LDH in two groups significantly increased at T₁,T₂ and T₃(P<0.01).The levels of cTnI at T₃,CK at T₂ and T₃,CK-MB at T₁ and LDH at T₁,T₂ and T₃ in group S were significantly lower than those in group C(P<0.01 and P<0.05).The differences of gerenal condition and total amount of dopamine using between two groups were not statistically significant(P>0.05).Conclusions: Sevoflurane post-processing can reduce the myocardial enzyme releasing in patients treated with heart valve replacement under cardiopulmonary bypass,alleviate the injury of myocardial ischemia-reperfusion and protect the myocardum.