温血灌注与冷晶体心脏停搏液灌注对心肌酶学的影响  

Influence of Warm Blood Cardioplegic Solution Perfusion and Cold Crystalloid Cardioplegic Solution on Myocardial Enzyme

作　　者：法宪恩[1] 庄世才[1] 张大新[1] 白增祥 

机构地区：[1]河南医科大学第二附属医院心外科

出　　处：《中国胸心血管外科临床杂志》1999年第2期103-105,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的比较温氧合血连续灌注与冷晶体心脏停搏液间断灌注心肌酶学变化，探索更有效的心肌保护方法。方法将阻断时间在６０分钟以上１６例患者随机分为温血灌注组（Ａ组）和冷晶体灌注组（Ｂ组），每组８人。分别于主动脉阻断前和主动脉阻断６０分钟后取部分心肌组织测定其超氧化物歧化酶（ＳＯＤ）和脂质过氧化物（ＬＰＯ）并进行对比分析。结果阻断前和阻断后２组ＳＯＤ和ＬＰＯ含量无差异，阻断后Ｂ组ＳＯＤ含量比阻断前显著降低（Ｐ＜０．０１）；而阻断后ＬＰＯ含量明显增高（Ｐ＜０．０１）。结论温血连续灌注能有效减轻心肌缺血与再灌注损伤，满足心肌需氧代谢。Objective To compare the changes of superoxide dismutase (SOD) and lipoperoxide(LPO) in warm oxygenated blood cardioplegic continuous perfusion (gruop A) and with those of cold crystalloid cardioplegic intermittent perfusion (group B) to find the effective method of myocardial preservation. Methods Sixteen patients were randomly divided into group A and group B with 8 cases in each group. A piece of myocardium tissue for SOD and LPO content testing was obtained from before clamping the aorta and 60 minutes after clamping the aorta. Results The SOD and LPO content of group A showed no difference between those before and 60 minutes after clamping the aorta, but SOD content of group B decreased from 713.63±120.70 before clamping the aorta to 241.73± 76 30 after clamping the aorta ( P <0 01) and the LPO content increased significantly from 0.0307±0.0042 before clamping the aorta to 0.0904±0.0100 after clamping ( P <0.01). Conclusion Warm oxygenated blood perfusion for myocardial preservation can effectively decrease the injury of ischemia/reperfusion of myocardium and meet the necessity of the aerobic metabolism and keep the stability of antioxide system of arrested myocardium.

关 键 词：心肌保护 温血 心脏停搏液 冷晶体 心肌醇 

分 类 号：R654.205[医药卫生—外科学]