五种心脏停搏液对未成熟心肌保护效果分析  

The protective effects of five kinds of cardioplegia on immature myocardium during cardiopulmonary bypass

作　　者：孟保英[1] 吴文智 丁以群[1] 张青[1] 潘晓兰[1] 王元祥[1] 彭乐[1] Meng Bao-ying Wu Wen-zhi Ding Yi-qun Zhang Qing Pan Xiao-lan Wang Yuan-xiang Peng Le(Deparment of Cardiovascular surgery, Shenzhen Children＇s Hospital, Shenzhen, 518026, China)

机构地区：[1]深圳市儿童医院心血管外科,深圳518026

出　　处：《中国体外循环杂志》2017年第3期129-132,共4页Chinese Journal of Extracorporeal Circulation

基　　金：深圳市科技计划资助(JCYJ20150403100317074)

摘　　要：目的比较五种心脏停搏液对心脏直视手术的未成熟心肌保护效果。方法随机将180例非紫绀型先天性心脏病患儿分成5组:HTK液组(A组)、改良St·Thomas液组(B组)、4∶1(自体血∶晶体)含自体血冷心脏停搏液组(C组)、1∶1(自体血∶晶体)含自体血冷心脏停搏液组(D组)和1∶4(自体血∶晶体)含自体血冷心脏停搏液组(E组)。五组患儿平均年龄(5.8±0.4)月,平均体重(6.1±0.3)kg。体外循环时间42~105(68.2±5.3)min,主动脉阻断21~68(38.4±4.6)min。对比分析体外循环前1 h及术后6 h、12 h及48 h肌钙蛋白I(cTnI)和磷酸肌酸酶同工酶(CKMB);术前及术后1 h、6 h左室射血分数(LVEF)。结果各组患儿体外循环前1 h及术后48 h cTnI及CKMB无显著性差异,术前及术后6 h LVEF均无统计学差异(P>0.05);HTK液组及1∶4含自体血冷心脏停搏液组术后6 h及12 h cTnI及CKMB较其他三组低,存在显著差异(P<0.05);HTK液组及1∶4含自体血冷心脏停搏液组术后1 h LVEF较其他三组高,存在显著差异(P<0.05)。结论 HTK液、1∶4含自体血冷心脏停搏液对未成熟心肌心肌保护作用较好。Objective To analyze the protective effects of five kinds of cardioplegia on immature myocardium during cardiopulmonary bypass.Methods 180 cases of non-cyanotic congenital heart disease were divided randomly into 5 groups：group HTK,group St.Thomas,group 4 ∶ 1 cold self-blood cardioplegia,group 1 ∶ 1 cold self-blood cardioplegia,group 1 ∶ 4 cold self-blood cardioplegia.Compare levels of cTnI and CKMB of 1 hour before operation,6 hours,12 hours and 48 hours after operation,as well as LVEF 1 h and 6 h before operation and after operation.Results There were no significant differences in cTnI and CKMB between 1 h before and 48 h after operation（ P〉0.05）.There were no significant differences in LVEF between preoperation and 6 hours after operation（ P〉0.05）.Levels of cTnI and CKMB in group HTK and group 1 ∶ 4 cold self-blood cardioplegia were lower than other groups in 6 and 12 hours after operation（ P〈0.05）;LVEF of group HTK and group 1 ∶ 4 cold self-blood cardioplegia were higher than the other three groups in 1 hour after operation（ P〈0.05）.Conclusion The HTK and cold self-blood cardioplegia with ratio 1 ∶ 4 had better immature myocardial profective effects.

关 键 词：先天性心脏病 自体血心脏停搏液 左室射血分数 心肌酶 

分 类 号：R726.5[医药卫生—儿科]