磷酸肌酸停搏液对缺血心肌的保护作用  

Study of the myocardial protective effect of creatine phosphate cardioplegia

作　　者：王涛[1] 李守先[1] 

机构地区：[1]山东医科大学附属医院,济南250012

出　　处：《上海医学》2001年第1期38-40,共3页Shanghai Medical Journal

摘　　要：目的　探讨外源性磷酸肌酸 (creatinephosphate ,CP)在心脏直视手术中作为添加剂加入心脏停搏液中对缺血心肌的保护作用。方法　 6 6例接受心内直视手术的患者分为对照组 (Ⅰ组 )及试验组 (Ⅱ组 ) ,各 33例。Ⅰ组使用冷晶体停搏液 ,Ⅱ组在Ⅰ组停搏液中加入CP。于不同时段取血样检测 5种心肌酶的含量。结果两组心肌酶含量 ,术前差异无显著性 ;术后Ⅱ组心肌酶谱上升幅度低于Ⅰ组 ,而下降速度则快于Ⅰ组。Objective To evaluate the myocardial protective effect of exogenous creatine phosphate (CP) when added to cardioplegia during open heart surgery. Methods 66 patients (28 males and 38 females, 2～58 years) were divided into control group (group Ⅰ, n =33) and CP group (group Ⅱ, n =33). Group Ⅰ received cold crystalloid cardioplegic solution in which human albumin was added. Group Ⅱ received almost the same as group Ⅰ with addition of CP(NEOTON) 2.5 g/L, 10 mmol/L. All patients were operated in open heart surgery with intravenous inspiration complex anesthesia、medial hypothermia (25～28℃) and cardiopulmonary bypass (CPB). CPB and cross clamp time were recorded. The serum myocardial enzymes (CPK MB, CPK, LDH, HBDH, AST) were determined preoperatively, right after crossclamp removal, weaning from CPB and 2、4、6、12、24、48 hours after cross clamp removal. Results There was no statistical significance between the enzymes at the time of CPB、cross clamp and preoperatively in group Ⅰ and Ⅱ. The amplitudes of elevation of serum myocardial enzymes after operation in group Ⅱ were lower than those in group Ⅰ but the descending rate was much more rapid. Conclusion Exogenous creatine phosphate added to the cardioplegia gives rise to better protective myocardial effect.

关 键 词：心肌保护 心脏停搏液 磷酸肌酸 心内直视术 心肌缺血 

分 类 号：R654.2[医药卫生—外科学]