脱中性粒细胞温血心脏停搏液连续灌注在心脏手术中心肌保护的研究  

Study on the effect of leukocyte-depleted cardioplegia perfusion in myocardial protection during heart operations

作　　者：权晓强[1] 法宪恩[2] 程兆云[1] 顾以苘[1] 

机构地区：[1]河南省人民医院心外科,郑州市450003 [2]郑州大学二附院心外科,郑州市450000

出　　处：《实用诊断与治疗杂志》2004年第6期489-490,496,共3页Journal of Practical Diagnosis and Therapy

基　　金：河南省自然科学基金资助项目;项目编号 :0 31 1 0 4 0 30 0

摘　　要：目的 :研究体外循环期间常温血脱中性粒细胞心脏停搏液微流量连续灌注对心脏瓣膜置换术中心肌的保护作用。方法 :临床随机选取体外循环时间在 60min以上的风湿性心脏瓣膜病人 2 0例 ,随机分为实验组和对照组 (每组 10例 ) ,分别检测不同时间点血浆心肌肌钙蛋白I(cTnI)水平和血浆MDA水平的变化。结果 :①两组病人在CPB前cTnI含量组间差异无显著性 ,而在主动脉阻断后及主动脉开放后各时间点差异显著 ,对照组cTnI值高于实验组 (P <0 .0 5 ) ;②两组病人在体外循环前及主动脉阻断 3 0min时MDA的含量组间差异无显著性 ,而在主动脉开放各时间点组间差异具有显著性 (P <0 .0 5 ) ,对照组高于实验组。结论 :实验研究证实 ,脱除心脏停搏液中的中性粒细胞后 ,可减轻中性粒细胞介导的心肌损伤 。Objective To evaluate clinically the myocardial protective effect of leukocyte-depleted blood cardioplegia (LDBCP) in valve replacement patients.Methods Twenty patients with rheumatic heart valvular diseases were respectively selected and divided randomly into control group(10 cases) and experiment group(10 cases). Arterial plasma levels of Troponin I(cTnI) and malondialdilyde (MDA) were determined in different time during operations. Results ①There were significant differences between two groups in cTnI levels at the points of T2 to T5(P<0.05),but no significant differences of T1(P>05). The cTnI levels of control group were higher than that of experiment group. ②There were significant difference between two groups at the points of T3 to T5 (P<0.05),but no significant differences of T1 and T2 (P>05). The MDA levels of control group were higher than that of experiment group.Conclusion Leukocyte infiltration in cardiac surgery can reduce the myocardial damage by activated nuutrophils. Therefore , leukocyte-depleted blood cardioplegia may be as a valuable method in the cardiac surgery.

关 键 词：中性粒细胞 心脏停搏液 对照组 温血 心肌保护 体外循环 术中 病人 主动脉阻断 心脏手术 

分 类 号：R654.2[医药卫生—外科学] R542[医药卫生—临床医学]