含不同比例自体血冷心脏停搏液对未成熟心肌线粒体结构及术后心功能的影响  

Effects of different proportions of autologous blood cardioplegia on mitochondrial structure and postoperative cardiac function in immature myocardium

作　　者：孟保英[1] 张青[1] 潘晓兰[1] 丁以群[1] 王元祥[1] 彭乐[1] 

机构地区：[1]深圳市儿童医院心血管外科,广东深圳518026

出　　处：《泰山医学院学报》2017年第10期1088-1091,共4页Journal of Taishan Medical College

基　　金：深圳市科技计划资助项目(项目编号:JCYJ20150403100317074)

摘　　要：目的探讨含不同比例自体血冷心脏停搏液对体外循环下未成熟心肌线粒体结构及术后心功能的影响。方法年龄≤1Y,体重≤10 kg,体外循环心脏直视手术患儿220例,随机分成HTK液灌注组(A组,n=20)、改良ST.Tomas液灌注组(B组,n=50),4∶1含自体血停搏液组(C组,n=50),1∶1含自体血停搏液组(D组,n=50),1∶4含自体血停搏液组(E组,n=50),透视电镜观察心肌线粒体超微结构改变,采用彩色多普勒超声仪及无创心功能检测仪评估术后心功能改变。结果 A组心肌线粒体评分及术后1 h左心室射血分数(LVEF)、CI明显高于其他组(P<0.05),E组心肌线粒体评分及术后1 h LVEF、CI高于其他三组(P<0.05),C、D组心肌线粒体评分及术后1h LVEF、CI无统计学差异(P>0.05)。结论 1∶4含自体血心脏停搏液对未成熟心肌保护优于其他含血心脏停搏液。Objective： To observe the effect of cold self-blood cardioplegia with different ratio to the mitochondrial ultrastructure parameters and heart function after opening cardiac operation by cardiopulmonary bypass（ CPB）. Methods： 220 infantile patients with congenital heart disease underwent operation by CPB were randomized into five groups according to the different of cardioplegia solution group： HTK solution group（ n = 20,A group）,ST. Thomas solution group（ n = 50,B group）,cold blood cardioplegia with ratio 4 ∶ 1（ n = 50,C group）,cold blood cardioplegia with ratio 1 ∶ 1（ n = 50,D group）,cold blood cardioplegia with ratio1∶ 4（ n = 50,E group）. The hear tissue of right atrial was collected five minutes before CPB and five minutes after aortic declamping. The heart tissue was withdrawn for homogenate. The myocardial ultrastructure were analyzed. LEVF were examined before 1d and after 1 h、6 h of operation. CI were examined after 1 h and 6h of operation. Results： Compared with five groups,the Flameng score of mitochondrial ultrastructure of A and E groups was higher than other groups（ P〈0. 05）. The Flameng score of mitochondrial ultrastructure had no significant differen between C and D groups（ P〈0. 05）. LVEF and CI of A and E groups afer 1 h of operationwas was higher than other groups（ P〈0. 05）. LVEF and CI afer 1h of operation had no significant differen between C and D groups（ P〈0. 05）. Conclusion： The cold self-blood cardioplegia with ratio 1∶ 4 was useful to the immature myocardial profection underwent opening cardiac operation by CPB in infant.

关 键 词：心脏病/先天性 心脏停搏液 线粒体 心肌 心功能 

分 类 号：R726.5[医药卫生—儿科]