浅低温不停跳行心内直视手术对未成熟心肌保护作用的实验研究  

Experimental study of immature myocardial protection of heart surgery on beating heart and mild hypothermia CPB

作　　者：陈华夏[1] 刘邕波[2] 熊荣生[2] 刘陶文[2] 杨娜[1] 

机构地区：[1]桂林医学院,广西桂林541004 [2]广西壮族自治区南溪山医院

出　　处：《山东医药》2009年第47期7-9,共3页Shandong Medical Journal

基　　金：广西壮族自治区卫生厅立项课题(Z2006141)。

摘　　要：目的探讨浅低温体外循环(CPB)心脏不停跳行心内直视手术对未成熟心肌的保护作用及机制。方法将16只同种健康幼犬随机分为观察组和对照组各8只,观察组在浅低温CPB心脏不停跳下行心内直视手术,对照组在冷晶体液间断灌注心脏停跳下行心内直视手术,测定两组不同时点血清中肌钙蛋白-I(cTn-I)、心钠素(ANP)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平的变化。结果对照组MDA、cTn-I和ANP在CPB期间逐渐升高,恢复正常灌注后升高更明显;观察组MDA、cTn-I和ANP虽也有升高,但较对照组低,且恢复正常灌注后无升高趋势。两组SOD活性均降低,但观察组SOD活性高于对照组。结论不停跳行心内直视手术可有效避免心肌的缺血—再灌注损伤,对未成熟心肌有良好的保护作用。Objective To investigate the immature myocardial protective effects and mechanism of of heart surgery on beating heart and mild hypothermia CPB. Methods Sixteen healthy and homogeneous minor dogs were randomly divided into two groups,the observed group accepted open -heart surgery on beating heart under cardiopulmonary bypass and mild hypothermia,while the control group accepted open -heart surgery under the condition of dosed cold crystalloid cardioplegia intermittently. The blood sample were taken in different time and the changes of cTn-Ⅰ, ANP, SOD, MDA were measured. Resuits The level of cTn-Ⅰ,ANP,MDA in the control group increased gradually during CPB,which were especially higher after the recovery of perfusion. The level of cTn-Ⅰ, ANP, MDA in the observed group also increased during CPB, but lower that that in the control group , and there was no increasing trend after the recovery of perfusion. The activity of SOD in two groups both decreased during CPB, but which in the the observed group was higher. Conclusions Beating heart surgery with mild hypothermic can prevent ischemia-reperfusion injury and protect immature heart better.

关 键 词：心肌保护 未成熟 浅低温 不停跳 心内直视术 

分 类 号：R654.2[医药卫生—外科学]