血停跳液对复杂型先天性心脏病心肌保护作用的研究  

CLINICAL STUDY 0N MYOCARDIAL PROTECTION WITH BLOOD CARDIOPLEGIA IN OPERATION FOR COMPLEX CONGENITAL HEART DISEASE

作　　者：zhu Ping Wang Zengwei (Zhujiang Hospita1 , First Military Medical University, Guangzhou 5l0282) 

机构地区：[1]广州第一军医大学珠江医院

出　　处：《解放军医学杂志》1995年第6期415-417,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：在５２例复杂先天性心脏病心内矫正术中，应用血停跳液（ＢＣＰ）加强心肌保护，与晶体停跳液（ＣＣＰ）比较。记录转流前和再灌注１０ｍｉｎ时心肌ＡＴＰ、环磷酰胺（ＣＰ）含量及术前，术后６、１２、２４、４８、７２ｈ内肌酸磷酸激酶（ＣＰＫ）、肌－脑混合肌酸磷酸激酶同工酶（ＣＫ－ＭＢ）、天门冬氨酸氨基转移酶（ＡＳＴ）、乳酸脱氢酶（ＬＤＨ）变化。结果显示：ＢＣＰ组心肌ＡＴＰ、ＣＰ贮备较ＣＣＰ组增加；术后７２ｈ内，ＢＣＰ组ＣＫ－ＭＢ值低于ＣＣＰ组。其峰值只是ＣＣＰ组的５５．２％（Ｐ＜０．０５）。血停跳液能增加心肌能量储备，提高心肌抗缺血的能力，减轻心肌损伤的程度。ＢＣＰ心肌保护的效果优于ＣＣＰ．The paper reported the study on myocardial protection during open heart surgery in 52 cases with complex congenital heart disease。 Twenty-six cases received blood cardioplegia (BCP)and the other half received crystalloid cardioplegia (CCP). The high energy phosphate content was determined before cardiopumonary bypass and l0 minute safter reperfusion。 Release of serun1 enzymes (CPK, CK-MB, AST and LDH) was determined preoperatively, and at 6,12, 24, 48 and 72 postoperative hours。 The results showed that myocardial ATP and CP contents in BCP group were higher than that in CCP group after l0 minutes of reperfusion.During the first 72 postoperative hours, level of CK-MB in BCP group was lower than that in CCP group. The peak value of CK- MB in the 2 groups were very different. CK- MB released in BCP groups l2 h after operation was 50. 38±8.53 vs 91. 26±10. 21 U/L in CCP group(P<0.05). In the CCP group, CK- MB level increased significantly even 72 h after operation (40. 32±ll.34). The re- sults showed that BCP could maitain metabolic homeostasis of the myocardium, reduce myocardial injury and increase myocardial high energy phosphate content during ischemia, BCP was superrior to CCP for myocardial protection。

关 键 词：心停跳液 心肌保护 先天性心脏病 心脏外科手术 

分 类 号：R541.1[医药卫生—心血管疾病] R654.2[医药卫生—内科学]