三种不同心肌保护液在胎羊体外循环中对心肌保护作用的比较  

A comparative study of three kinds of cardioplegias on myocardial preservation in fetal lambs during cardiopulmonary bypass

作　　者：温树生[1] 郭颜芳[1] 雷迪斯[1] 何标川[1] 李晓华[1] 梁杰贤[1] 张勇[1] WEN Shu-sheng GUO Yan-fang LEI Di-si HE Biao-chuan LI Xiao-hua LIANG Jie-xian ZHANG Yong(Department of Cardiac Surgery, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510100, China)

机构地区：[1]广东省心血管病研究所心外科广东省人民医院(广东省医学科学院),广州510100

出　　处：《岭南心血管病杂志》2017年第3期322-326,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨St.Thomas液,1∶4含血灌注液以及HTK液在胎羊体外循环中对心肌的保护作用。方法孕羊24只,随机分为4组:仅体外循环对照组(A组);加入St.Thomas液组(B组);加入1∶4含血灌注液组(C组);加入HTK液组(D组)。在转流前、转流30 min、停止体外循环后30 min、60 min和120 min记录胎羊的血压,抽血检测血氧、血二氧化碳、酸碱平衡以及磷酸肌酸激酶同工酶(creatine kinase isoenzyme MB,CKMB)和心肌肌钙蛋白I(cardiac troponin I,cTnI)浓度。结果体外循环结束120 min,B组血氧分压显著低于A组,差异有统计学意义(P<0.05);B、C组血二氧化碳分压明显高于A组,pH明显低于A组,差异有统计学意义(均P<0.05);且相对于D组,B组血二氧化碳分压明显升高,pH降低,差异有统计学意义(均P<0.05)。体外循环结束60 min时,B组血压明显低于A组,差异有统计学意义(P<0.05)。在体外循环时及结束后,B、C、D组磷酸CKMB浓度明显高于A组,且在停止循环60 min及120 min时,B组CKMB浓度显著高于D组,差异有统计学意义(均P<0.05)。体外循环时,B、C、D组cTnI浓度明显高于A组,差异有统计学意义(P<0.05)。在体外循环结束120 min,B、C组cTnI浓度明显高于A组,B组显著高于D组,差异有统计学意义(均P<0.05)。结论在胎羊体外循环中,1∶4含血灌注液与HTK液能良好地保护胎羊心肌,效果明显优于St.Thomas液,且HTK液心肌保护作用略好于1∶4含血灌注液。Objectives To elevate the effect of St.Thomas solution,blood cardioplegia solution and HTK solution inmyocardial preservation in fetal lambs during cardiopulmonary bypass（CPB）. Methods Twenty four ewes weredivided into four groups randomly：control group（A group）,St.Thomas solution group（B group）,blood cardioplegiasolution（C group）and HTK solution group（D group）. Blood pressure,blood oxygen,blood carbon dioxide,pH,creatine kinase isoenzyme MB（CKMB）and cardiac troponin I（cTnI）before CPB,at CPB for 30 min,30 min,60 minand 120 min after CPB were detected respectively. Results At 120 min after CPB,pressure of oxygen in B group wassignificantly lower than that in A group（P〈0.05）,pressure of carbon dioxide in both B and C group were much higherthan that in A group（P〈0.05）,and pH value were significantly lower than that in A group（P〈0.05）. Compared with Dgroup,pressure of carbon dioxide in B group was higher and pH value was lower outstandingly（P〈0.05）. At 60 minafter CPB,blood pressure in B group was lower than that in A group remarkably（P〈0.05）. During and after CPB,concentration of CKMB in B,C and D group were much higher than in A group. Additionally,60 min and 120 minafter CPB,concentrations of CKMB in B group were significantly higher than those in D group（P〈0.05）. During CPB,concentrations of cTnI in B,C and D group were higher than that in A group（P〈0.05）. And 120 min after CPB,concentrations of cTnI in B and C group were much higher than that in A group（P〈0.05）. Besides,concentration of cTnI in B group was higher than that in D group（P〈0.05）. Conclusions During CPB in fetal lambs,bloodcardioplegia solution and HTK solution could protect myocardial excellently and the effects are both superior to St.Thomas solution remarkably. In addition,the myocardial preservation of HTK solution is slightly better than bloodcardioplegia solution.

关 键 词：胎羊 体外循环 St.Thomas液 1∶4含血灌注液 HTK液 

分 类 号：R654.1[医药卫生—外科学]