心脏手术不停搏与停搏对心肌细胞因子表达的影响  被引量:1

Effects of Beating Heart and Arrested Heart Intracardiac Procedure on the Expression of Cytokine in Myocardium

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作  者:张喆[1] 肖颖彬[1] 陈林[1] 王学锋[1] 钟前进[1] 王惠春[1] 刘梅[1] 彭莉[1] 胡卫[1] 

机构地区:[1]第三军医大学新桥医院心血管外科,重庆400037

出  处:《中国体外循环杂志》2005年第2期74-76,共3页Chinese Journal of Extracorporeal Circulation

摘  要:目的探讨心脏不停搏和停搏心内直视手术对心肌肿瘤坏死因子α-mRNA的表达的影响。方法30例年龄5~10岁的先天性室间隔缺损患儿,随机等分为两组。组1在中低温体外循环心脏停搏下完成手术,组2在浅低温体外循环心脏跳动下完成手术。在打开与关闭右心房时取心肌组织检测TNF-αmRNA表达。分别于麻醉诱导后(T1),CPB转流20min(T2),CPB结束时(T3),停机后6h、12h、24h(T4-6)抽血检测血浆TNF-α浓度。结果两组患者心肌TNF-αmRNA表达水平在关闭右房时均明显升高(P<0.05),且组1明显高于组2(P<0.05)。组1血浆TNF-α浓度在T4~6时间点明显高于组2(P<0.05)。结论心脏不停搏心内直视手术较传统心脏停搏手术方式能减少的TNF-α表达与释放,有利于小儿体外循环期的心肌保护。OBJECTIVE To explore the effects of beating heart and arrested heart intracardiac procedure on the expression of tumor necrosis factor alpha (TNF-α) mRNA in myocardium.METHODS 30 congenital VSD patients aged from 5 to 10 years were randomly divided into two groups equally. Group 1 was undergone in traditional arrested heart intracardiac procedures; Group 2 was undergone in beating heart procedures. Specimens of myocardium were obtained while the right atrium was opened (baseline) and closed for the determination of TNF-αmRNA. Concentration of TNF-αwas respectively measured after anesthetic induction (T1), 20 minutes after the beginning of CPB (T2), at the end of CPB (T3) and 6, 12, 24 hour after CPB (T4-6) in all patients. RESULTS Compared with baseline, the expression of TNF-αmRNA was significantly increased in both groups (P<0.05). TNF-αmRNA level of group1 was significantly higher than that of group 2 while the right atrium was being closed (P<0.05). The plasma concentration of TNF-α in group1 was significantly higher than that of group 2 at T4-6(P<0.05). CONCLUSION Compared with traditional arrested CPB, beating heart intracardiac procedure can effectively reduce the expression and release of TNF-α; it will benefit the protection of pediatric myocardium during CPB.

关 键 词:心内直视手术 肿瘤坏死因子 心脏不停搏 体外循环 

分 类 号:R726.5[医药卫生—儿科]

 

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