不停跳心内直视手术对心肌细胞凋亡的影响  

The effect of Beating Heart Surgery On Myocardial apoptosis

作　　者：章文龙[1] 李勇生[1] 杨文东[1] 魏崴[1] 

机构地区：[1]惠州市中心人民医院心胸外科,516001

出　　处：《中国现代药物应用》2009年第12期1-3,共3页Chinese Journal of Modern Drug Application

摘　　要：目的通过前瞻性检测停跳组与不停跳组心肌细胞的凋亡指数,心肌酶变化,评价停跳与不停跳手术的心肌保护效果。方法将33例心脏手术患者分为停跳组(n=18)和不停跳组(n=15),分别在术中体外循环转机前及停机时留取右心耳心肌组织,用原位DNA末端标记技术,光学显微镜下检测标本心肌凋亡细胞,计算凋亡指数。结果停跳组和不停跳组术前心肌细胞凋亡指数无显著性差异(P>0.05),但在术后停跳组心肌细胞凋亡指数比不停跳组增高(P<0.05),停跳组和不停跳组术前cTnT无显著性差异(P>0.05),但在CPB末和术后2h停跳组cTnT比不停跳组增高(P<0.05)。结论心肌细胞凋亡在不停跳心脏手术中比在停跳心脏手术中低;不停跳心脏手术比停跳心脏手术显示了更好的效果。Objective Prospectively detect the apoptosis index in beating heart patients and conventional ones and compare serum level of cTnT to contrast the myocardial protection of the two kinds of surgical operations. Methods A total of 33 cases undergoing cardiac operation were divided into 2 groups： 18 cases consisted of beating heart group and 15 cases consisted of arrested heart group, the apoptosis index, serum level of cTnT were analyzed. Results There was no significant difference of myocardial apoptosis between 2 groups, while postoperatively myocardial apoptosis of the arrested heart group increased statistically significantly compared to the bearting heart group;There were no significant difference of the serum level of cTnT between 2 groups,while at the end of CPB and two hours after operation the serum level of cTnT of the arrested heart group increased statistically significantly compared to the bearting heart group. Conclusion The myocardial apoptosis induced by beating heart surgery were less than those induced by the arrested one; the beating heart surgery has better myocardial protection than the arrested one.

关 键 词：不停跳心脏手术 心肌保护 肌钙蛋白T 心肌细胞凋亡 

分 类 号：R654.2[医药卫生—外科学] R542.2[医药卫生—临床医学]