胎羊心脏转流对胎羊心功能的影响  

Fetal cardiac function in fetal cardiac bypass

作　　者：周成斌[1] 张镜芳[1] 庄建[1] 温树生[1] 刘彦英[2] 章晓华[1] 

机构地区：[1]广东省人民医院广东省心血管病研究所心外科,广州510100 [2]广东省人民医院广东省心血管病研究所B超室,广州510100

出　　处：《中华胸心血管外科杂志》2007年第5期329-331,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(30300346);广东省自然科学基金(033187)资助

摘　　要：目的探讨胎羊心脏转流对不停跳下胎羊心功能的影响。方法孕120～140 d 母羊8只,共孕9只胎羊,随机分为对照组(n=4)和胎羊体外循环组(CPB 组,n=5)。对照组胎羊开胸,不建立体外循环。CPB 组建立胎羊心脏转流模型,转流30 min。分别于转流前、转流30 min、转流结束后1 h、2 h测胎羊平均动脉压、心率和动脉血气值。观察血肌钙蛋白(TnI)含量的变化,B 超检测左、右心室 Tei 指数和脐动脉搏动指数(PI),观察心肌超微结构变化。结果两组胎羊平均动脉压、心率无显著变化。CPB 组胎羊脱离体外循环后出现高碳酸血症和酸中毒,血氧分压无显著变化。对照组胎羊血气值无明显变化。CPB 组胎羊左右心室 Tei 指数、脐动脉 H、血 TnI 含量均显著大于对照组(P<0.05)。CPB 组胎羊心肌细胞糖原明显减少。结论胎羊心脏转流对胎羊心功能造成损害,心功能不良与胎盘功能不良存在相互影响。Objective To study the effects of fetal lamb cardiac bypass on the fetal cardiac function. Methods Eight ewes at gestation of 120 to 140 days have nine fetus which were randomly divided into control group （n = 4） and fetal bypass group （n = 5）. Control group underwent sham procedure that fetal sternotomy was performed. Bypass group underwent fetal cardiac bypass with centrifugal pump and placenta for 30 minutes. Fetal mean blood pressure, heart rate and blood gas data were recorded before bypass, 30 minutes during bypass, 1 hour after cessation of bypass, 2 hour after cessation of bypass. Tei index of two ventricles and pulse index of umbilical arteries were recorded with ultrasonography. Plasma troponin Ⅰ was assayed. Ultrastructure of fetal myocardiura was recorded. Results Fetal mean blood pressure and heart rate of two groups have no changes during the experiment time. The umbilical pulse index of bypass group elevated significantly compared with control group （ P 〈 0.05）. Tei index of left and fight ventricle of bypass group increase remarkably compared with control group （ P 〈0.05）. There was no significant difference in Tei index between left and fight ventricle. Fetal lambs in bypass group showed hypercarbia and acidosis after cessation of bypass（ P 〈 0.05）. Fetal arterial oxygen tension of two groups remained normal. Plasma troponin Ⅰ in bypass group increased remarkably compared with control group （P〈0.05）.Ultrastrcutrue of myocardium show the decrease of glycogen in myocyte of bypass group. Conclusion Fetal cardiac bypass is detrimental to the fetal ! cardiac function, which may interact with fetal-placental circulation and further worsen the tetal circulation.

关 键 词：体外循环 心室功能 胎盘功能 胎羊 

分 类 号：R714.5[医药卫生—妇产科学]