全胸腔镜下心脏停跳与不停跳心内直视手术对心肌mPTP开放程度及CF6表达的影响对比  

Effects of total thoracoscopic cardiac arrest and open beating heart surgery on myocardial m PTP openness and CF6 expression

作　　者：马刚[1] 毕淑婷 王盛 

机构地区：[1]淄博市中心医院心脏外科,山东淄博255036

出　　处：《现代医学》2017年第9期1256-1260,共5页Modern Medical Journal

摘　　要：目的:探讨腔镜下心脏停跳与不停跳心内直视手术对心肌线粒体通透性转换孔(mPTP)开放程度、线粒体偶联因子6(CF6)表达量的影响差异。方法:依据随机数字表法,将56例风湿性心脏病患者分别纳入观察组(全胸腔镜下心脏不停跳直视手术)或对照组(全胸腔镜下心脏停跳直视手术),每组28例;比较两组患者手术实施情况指标、不同时间点下心肌损伤指标(乳酸脱氢酶、肌酸激酶同工酶、肌钙蛋白T)的变化,开关右心房时mPTP开放程度及CF6值的变化趋势。结果:观察组除手术用时长于对照组外,在主动脉阻断时间、体外循环时间、ICU监护时间、住院天数、住院费用指标上均优于对照组,差异具有统计学意义(P<0.05);在心肌损伤指标中,观察组患者乳酸脱氢酶、肌酸激酶同工酶、肌钙蛋白T变化幅度小于对照组;此外,在术毕时观察组mPTP开放程度小于对照组,且患者血浆CF6表达量波动幅度小于对照组。结论:全胸腔镜下心脏不停跳心内直视手术可降低mPTP开放程度、抑制CF6表达过度增高,从而减少心肌损伤,提高术后恢度速度。Objective： To explore the effects of total thoracoscopic cardiac arrest and open beating heart surgery on myocardial mPTP openness and CF6 expression.Methods： According to the digital table method,56 cases of rheumatic heart disease were included in the observation group （total thoracoscopic open beating heart surgery） or control group （total thoracoscopic cardiac arrest surgery）,each group of 28 cases; the changes of mPTP opening degree and CF6 value in right atrium were measured at different time points,and the changes of myocardial injury index （lactate dehydrogenase,creatine kinase isoenzyme and troponin T） were compared between the two groups.Results： In the observation group,the duration of the operation was longer than that in the control group,and the differences were statistically significant （P〈0.05） in the time of aortic occlusion time,cardiopulmonary bypass time,ICU monitoring time,hospital stay and hospitalization cost.In the myocardial injury index,the changes of lactate dehydrogenase,creatine kinase isoenzyme and troponin T in the observation group were smaller than those in the control group.In addition,the degree of open mPTP in the observation group was smaller than that in the control group,the fluctuation of CF6 expression was smaller than that of the control group.Conclusion： Total thoracoscopic open beating heart surgery can reduce the degree of open mPTP,inhibit the excessive expression of CF6,thereby which can reduce myocardial injury and improve the rate of postoperative recovery.

关 键 词：心脏不停跳心内直视手术 心肌线粒体通透性转换孔 线粒体偶联因子6 心肌损伤 

分 类 号：R654.2[医药卫生—外科学]