不同心脏停搏液对体外循环中未成熟心肌保护作用的研究  

The Protective Effect of Different Cardioplegia on Immature Myocardium in Cardiopulmonary Bypass

作　　者：王鹏高[1,2] 罗淑颖[1,2] 牛松涛[3] 张卫东[4] 

机构地区：[1]郑州大学公共卫生学院 [2]郑州市儿童医院心胸外科,郑州450001 [3]河南省漯河市中心医院肿瘤科,河南漯河462000 [4]郑州大学公共卫生学院流行病与卫生统计学教研室,郑州450001

出　　处：《中国现代医生》2009年第12期20-22,共3页China Modern Doctor

摘　　要：目的探讨不同停搏液对未成熟心肌的保护作用,寻找最适用于婴幼儿的心肌保护措施。方法60名先天性心脏病患儿,随机分成HTK、STH和冷血停搏液灌注组,经主动脉根部灌注后测定血浆中ET-1、CK、CK-MB、cTnT的含量。结果停搏前ET-1、CK、CK-MB、cTnT的含量组间差异均无统计学意义(P>0.05);再灌注后患者在不同时间点含量不同,A组低于其他两组,差异均有统计学意义(P<0.05),不同停搏液其血浆中的含量比较,A组低于其他两组,差异均有统计学意义(P<0.05),不同停搏液和测量时间均无交互作用(P>0.05)。结论HTK停搏液对未成熟心肌的保护效果优于其他两组。Objective To focus primarily on comparing the myocardial protective effect of Histidine-Tryptophan-Ketoglutarate （HTK） cardioplegia with cold crystalloid eardioplegia and cold blood cardioplegia in infant open heart surgery, to explore the most suitable myocardial protective measures for infants and young children. Methods 60 infants with congenital heart disease were randomized into three groups. After cardiopulmonary bypass was instituted,and then the ascending aorta was clamped. Serum levels of endothelin-1 （ET-1）, ereatine kinase（CK）, creatine kinase M B （CK-MB）, and cardiac troponin T（eTnT） were measured. The data was analyzed by SAS9.13 statistical software. Results Before ischemia, cardiac function and leakage of myocardial enzyme were comparable in three groups with no significant differenee（P 〉 0.05 ）. After ischemia auto- beating ratio in group A were significantly lower than those in group B and C. ET-1 ,CK,CK-MB and cTnT leakage in group A were significantly lower than those in group B and C（P 〈 0.05 ）. Conclusion In the period of aortic cross-clamping, after perfusion HTK eardioplegia one-time,the effect of cardiac arrest gratification than the other two groups,and HTK cardioplegia can alleviate the ischemia-reperfusion injury to immature myocardium.

关 键 词：HTK停搏液 STH冷晶体停搏液 冷血停搏液 未成熟心肌 心肌保护 

分 类 号：R542.2[医药卫生—心血管疾病]