心肌保护液对婴幼儿先心病心肌保护的评价  

Evaluation on three kinds of cardioplegia on myocardial protection in infants with congenital heart disease

作　　者：敦静[1] 王伟[2] 

机构地区：[1]河北医科大学第四医院手术室,河北石家庄050011 [2]河北省成安县人民医院外科

出　　处：《西北国防医学杂志》2014年第3期239-241,共3页Medical Journal of National Defending Forces in Northwest China

基　　金：河北省卫生厅科技支撑计划资助项目(20090458)

摘　　要：目的:比较在传统心脏停搏液中加入L-精氨酸、L-精氨酸与腺苷和L-精氨酸、腺苷与组氨酸对心肌缺血/再灌注损伤的保护作用。方法:将60例法洛四联症婴幼儿随机分成3组,分别应用含L-精氨酸(A组)、L-精氨酸加腺苷(B组)和L-精氨酸、腺苷及组氨酸(C组)心脏停搏液灌注心脏。检测血清肌钙蛋白I(cTnI)、肌酸磷酸激酶同工酶(CKMB)含量。结果:B组血浆cTnI含量仅于主动脉开放2h显著降低(P<0.01),C组不但于主动脉开放后30min、2h和6h均显著低于A组(P<0.01或P<0.05),而且于主动脉开放2h、6h显著低于B组(P<0.01或P<0.05);C组血浆CKMB含量于主动脉开放后30min、2h、6h均显著低于A组(P<0.01或P<0.05),而在2h、6h也显著低于B组(P<0.01或P<0.05)。结论:加入L-精氨酸、腺苷和组氨酸心脏停搏液能显著减少cTnI、CK-MB的释放,较L-精氨酸和L-精氨酸与腺苷心脏停博液效果更好。Objective：To compare the myocardial protective effect of three cardioplegic solution respecti- vely added L-- arginine, L--arginine and adenosine and L--arginine, adenosine and histidine in traditional cardioplegic solution. Methods： Sixty patients with tetralogy of Fallot were randomly divided into three groups, respectively,L-- arginine（group A）, L-- arginine plus adenosine（group B） and L-- arginine, adenosine and histidine（group C）. Serum level,s of troponin I（cTnI）,creatine kinase isoenzyme（CKMB） content were tested in different time--point. Results： Plasma cTnI content in group B only significantly decreased （P〈0.01）2 h after opening aortic , group C plasma cTnI was significantly lower than that of group A（P〈0.01 or P〈0.05） not only in 30 rain,2 h and 6 h after opening aorta, but also significantly lower than those of group B after opening aortic： 2 h and 6 h（P〈0.01 or P〈0.05 ）. Plasma content of CK- MB in group C were significantly lower than that in group A in 30 min,2 h and 6 h after opening aorta （P 〈0.01 or P〈0.05 ）,and were significantly lower than that of group B （P〈0.01 or P〈0.05 ） in the 2 h and 6 h. Conclusion： L--arginine, adenosine and histidine cardioplegic solution can significantly reduce cT- nI, CKMB release,which has better effect thaa L--arginine and L--arginine and adenosine cardioplegic solution.

关 键 词：心脏停搏液 婴幼儿 心肌保护 L-精氨酸 腺苷 组氨酸 

分 类 号：R725.4[医药卫生—儿科]