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Abstract To observe the protective effect of remote ischemia preconditioning on myocardium and kidney of patients with rheumatic heart disease during valve replacement .[Methods]A total of 80 patients with rheumatic heart disease undergoing valve replacement were chosen and randomly divided into control group(group A ,n=40) and remote ischemia preconditioning group(group B ,n =40) .In group B ,the right thighs(2~3cm near knee joint) of patients were given 600mmHg pressure by tourniquet for 5min after aortic clamping under cardiopulmonary bypass ,and then the balloon was unclamped for 5min .The cycle was repeat-ed for 3 times .Venous blood samples were drawn to measure troponin I (cTnI) ,B-type natriuretic peptide (BNP),urea nitrogen(BUN),serum creatinine(Scr) and acute renal injury factor(Kim-1) before surgery (T1 ) ,5min before aortic de-clamping(T2 ) ,30min(T3 ) ,4h(T4 ) and 24h(T5 )after aortic de-clamping .[Re-sults]There was no significant difference in age ,weight ,cardiopulmonary bypass time ,aortic clamping time and preoperative cTnI ,BNP ,BUN ,Scr and Kim-1 between two groups( P>0 .05) with comparability .Com-pared with T1 ,the cTnI in two groups at T3 ,T4 and T5 were increased significantly ,while those in group B were significantly lower than those in group B ( P < 0 .05) .Compared before operation ,the BNP in two groups at T5 was increased significantly ,while that in group B was significantly lower than that in group A ( P<0 .05) .Compared with before operation ,BUN and Scr in two groups at T5 were increased significantly ,and those in group B were significantly lower than those in group A ( P<0 .05) .Compared with before operation , Kim-1 in two groups at T4 and T5 was increased significantly ,and that in group B was significantly lower than that in group B( P <0 .05) .[Conclusion]Remote ischemic preconditioning can protect the myocardial and re-nal function in patients with rheumatic heart disease undergoing valve replacement .
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2014, Vol. 31 
