法乐四联症患儿心肌细胞和红细胞内外钙的变化  

Changes of myocyte and erythrocyte calcium in children with tetralogy of fallot

作　　者：李自普[1] 刘豫阳[1] 沈惟堂[1] 陈张根[1] 桂永浩[1] 

机构地区：[1]上海医科大学儿科医院

出　　处：《中华儿科杂志》1997年第3期142-145,共4页Chinese Journal of Pediatrics

基　　金：国家自然科学基金

摘　　要：为了解法乐四联症（ＴＯＦ）患儿术前心肌舒张功能障碍的原因，采用钙荧光指示剂（Ｆｕｒａ－２）法和原子吸收分光光度（ＡＡＳ）法测定了１２例ＴＯＦ患儿心肌细胞、红细胞内外钙的变化。结果发现：ＴＯＦ术前心肌细胞游离钙（ＭｙｏＣａｉ）（３４７±８５ｎｍｏｌ／Ｌ）较先天性心脏病（简称先心病）组（１２２±１３ｎｍｏｌ／Ｌ）明显升高；红细胞游离钙（ＥｒｙＣａｉ）和红细胞总钙（ＥｒｙＣａｔ）（１．８９±０．５０Ｆ３３５／Ｆ３８５，２１．２±２．９μｍｏｌ／Ｌ红细胞）较先心病组（１．４７±０．０８Ｆ３３５／Ｆ３８５，１３．１±８．７μｍｏｌ／Ｌ红细胞）和健康组亦明显升高，而全血游离钙（ＢＣａｉ）和红细胞钠泵、钙泵活性明显下降。术后除钙泵活性外，ＢＣａｉ、ＥｒｙＣａｉ、ＥｒｙＣａｔ和红细胞钠泵活性均恢复正常。提示，钙内流增多和膜泵活性下降导致ＴＯＦ患儿心肌细胞和红细胞内存在过多钙积聚，可能是其术前舒张功能障碍的重要原因之一。To study the reason of pre operative diastolic dysfunction of tetralogy of Fallot (TOF) in children, we measured the concentrations of free calcium and total calcium in myocyte and erythrocyte in 12 children with TOF by using calcium fluorescence in dicator Fura 2 and atomic absorption spectrophotometry (AAS). The results showed that before operation for TOF, the concentrations of myocyte free calcium (347±85nmol/L) was significantly increased as compared with that of congenital heart diseases group (122±13nmol/L). The concentrations of erythrocyte free calcium (EryCai, 1.89±0.50F 335 /F 385 ) and erythrocyte total calcium [EryCat, 21.2±2.9μmol/L (cell)] were also obviously increased as compared with those of congenital heart disease group [(1.47± 0.08 F 335 /F 385 ,13.1±8.7μmol/L (cells)]and healthy group; whereas the concentration of blood free calcium (BCai) and the activities of membrane Ca pump and Na pump were markedly decreased. After operation, the concentrations of BCai,EryCai and EryCat and activity of Na pump but Ca pump of erythrocyte membane returned to their normal range. These results indicated that there was too much calcium accumulation in erythrocyte and myocyte due to calcium ions influx into the cells and the decline of membrane pump activities, which probably played an importent role in pre operative diastolic dysfunction of TOF patients.

关 键 词：法乐氏四联症 红细胞 钙 心肌细胞 儿童 

分 类 号：R725.411[医药卫生—儿科] R541.1[医药卫生—临床医学]