外源磷酸肌酸对未成熟心肌保护作用的临床研究  

Clinical Study on Immature Myocardial Protective Function of Creatine Phosphate

作　　者：陈圣杰[1] 廖斌[2] 易善永[2] 邓明彬[2] 詹福生[2] 

机构地区：[1]江苏大学附属医院胸心外科,江苏镇江212001 [2]泸州医学院附属医院胸心外科,四川泸州646000

出　　处：《江苏大学学报（医学版）》2004年第1期41-43,共3页Journal of Jiangsu University：Medicine Edition

摘　　要：目的 :探讨外源磷酸肌酸 (CP)在婴幼儿先天性心脏病矫治术中的心肌保护作用。方法 :将 2 0例室间隔缺损 (VSD)患儿 ,随机分为CP组和对照组 ,CP组在ST .Thomas′s停搏液中加入磷酸肌酸钠 (每 10 0 0ml中加入 2 5 g磷酸肌酸钠 )。观察两组心肌电生理指标 ,正性肌力药用量 ,分别于转流前、开放循环后 30min、术后 6、12、2 4h、采取桡动脉血检测肌酸激酶同工酶 (CK MB)、心肌肌钙蛋白I(cTnI)。取右心耳组织观察心肌超微结构。结果 :两组主动脉阻断时间无明显差异。术后 6h ,CP组cTnI为 (1 0 4± 0 5 9) μg/L ;CK MB为 (2 6 5 8± 3 2 1)U/L ,升高值明显低于对照组 (3 6 7± 0 6 2 ) μg/L ;(4 9 0 6± 11 2 9)U/L(P <0 0 1)。CP组心肌超微结构保存较好 ,损伤较对照组小。 结论 :CP作为有效的停搏液成分 ,对婴幼儿未成熟心肌产生保护作用。Objective:To investigate the myocardioprotective effects of creatine phosphate in infant undergoing open heart surgery.Methods:Twenty infant patients with ventricular septal defect (VSD) underwent operations on cardiopulmonary bypass.They were randomly devided into two groups: Creatine phosphate and control. Creatine phosphate was used through intravenous injection in the creatine phosphate group before the cardiopulmonary bypass.Cardiac electrophysiologic data and inotropic medicine dosage were measured.Mycocardium enzymes and cardiac troponin I (cTnI) were measured in each group before the cardiopulmonary bypass,30 min. after the aorta off clamping,and 6 hours,12 hours and 24 hours after operation.The changes of myocardial ultrastructure were studied.Results:There were no significant differences between the two groups in the time of the aorta clamping.At 6 hours after operation,The cTnI (1.04±0.59)μg/L and Ck-MB(26.58±3.21)U/L in the adenosine group were significantly lower than those in the control group (3.67±0.62)μg/L;(49.06±11.29)U/L(P<0.01).The inotropic medicine dosage in the creatine phosphate group was much lower than that in the control group.The myocardial ultrastructure in creatine phosphate group was less damaged than that in the control group.Conclusion: Creatine phosphate can enhances immature myocardial protection of crystal cardioplegic solutions.

关 键 词：磷酸肌酸 未成熟心肌 心肌保护 婴幼儿 先天性心脏病 室间隔缺损 

分 类 号：R972[医药卫生—药品] R725.4[医药卫生—药学]