自体冷血停搏液对非紫绀型未成熟心肌能量代谢的影响及意义  

Effects and significance of cold autologous blood cardioplegic solution on energy metabolism of immature and non-cyanosis congenital heart disease

作　　者：马超[1] 沈定荣[1] 张青[1] 王元祥[1] 彭乐[1] 赵春玉[1] 孟保英[1] 提运幸[1] 

机构地区：[1]广东省深圳市儿童医院心血管中心,深圳518026

出　　处：《中国体外循环杂志》2013年第4期196-199,共4页Chinese Journal of Extracorporeal Circulation

基　　金：深圳市科技计划项目(200902102)

摘　　要：目的探讨自体冷血停搏液对非紫绀型未成熟心肌能量的影响及意义。方法 65例先天性心脏病婴儿随机分为:异体冷血停搏液(A)组(n=32)和自体冷血停搏液(B)组(n=33),术前、术后即刻、术后6h、24h测左心室Tei指数、左心室射血分数(LVEF)及心指数(CI);主动脉阻断前和开放30 min取右心耳组织,检测ATP、ADP及能量储备(EC)。结果术后即刻、6h与24h Tei指数逐渐降低,各时间点B组较A组低,与B组的差异均有显著性(P<0.05);LVEF和CI逐渐升高,B组各时间点较A组高,与A组的差异均有显著性(P<0.05);主动脉开放30 min后,两组ATP、ADP和EC含量均显著降低(P<0.05),B组较A组高,差异有显著性(P<0.05)。结论非紫绀型未成熟心肌应用自体冷血停搏液比异体冷血停搏液能更好的保存心肌细胞能量,更有利于术后心脏功能的恢复。Objective To study the effects and significance of cold autologous blood cardioplegic solution on energy sub-stances of cardiocyte in infants with non-cyanotic congenital heart disease.Methods 65 infants with non-cyanotic congenital heart disease were randomly divided into cold xenogenous blood cardioplegic solution group(group A,n=32) and cold autologous blood car-dioplegic solution group(group B,n=33).Left ventricular Tei index,left ventricular ejection fraction(LVEF) and heart index(CI) were detected before operation,immediately after operation,and at postoperative 6h and 24h.Tissue of right auricle was taken before the aortic was clamped and 30minute after aortic clamping removal to measure the levels of ATP,ADP and energy reserve(EC) val-ue.Results Tei index gradually reduced after operation and at postoperative 6h and 24h,and it was significantly lower(P<0.05) in group B than that in group A at each time point.While,LVEF and CI gradually raised,and were significantly higher(P<0.05) in group B than those in group A at each time point.30mins after aortic clamping removal,ATP,ADP and EC content reduced signifi-cantly(P<0.05) in the two groups,and those datas were significantly higher(P<0.05) in group B than in group A.Conclusion Compared with cold xenogenous blood cardioplegic solution,cold autologous blood cardioplegic solution can more effectively save en-ergy of immature cardiocyte,and therefore is more beneficially for the recovery of patients' cardiac function after operation.

关 键 词：未成熟心肌 自体冷血停搏液 先天性心脏病 能量代谢 

分 类 号：R726.5[医药卫生—儿科]