不同心脏停搏液对体外循环中未成熟心肌保护作用探究.docVIP

不同心脏停搏液对体外循环中未成熟心肌保护作用探究[摘要] 目的 探讨不同停搏液对未成熟心肌的保护作用，寻找最适用于婴幼儿的心肌保护措施。方法 60名先天性心脏病患儿，随机分成HTK、STH和冷血停搏液灌注组，经主动脉根部灌注后测定血浆中ET-1、CK、CK-MB、cTnT的含量。结果 停搏前ET-1、CK、CK-MB、cTnT的含量组间差异均无统计学意义（P＞0.05）；再灌注后患者在不同时间点含量不同，A组低于其他两组，差异均有统计学意义（P＜0.05），不同停搏液其血浆中的含量比较，A组低于其他两组，差异均有统计学意义（P＜0.05），不同停搏液和测量时间均无交互作用（P＞0.05）。结论 HTK停搏液对未成熟心肌的保护效果优于其他两组。 [关键词] HTK停搏液；STH冷晶体停搏液；冷血停搏液；未成熟心肌；心肌保护 [中图分类号] R542.2 [文献标识码] A [文章编号] 1673-9701（2009）12-20-03 The Protective Effect of Different Cardioplegia on Immature Myocardium in Cardiopulmonary Bypass WANG Penggao1LUO Shuying1NIU Songtao2ZHANG Weidong3 1.Department of Epidemiology，College of Public Health，Zhengzhou University，Zhengzhou 450001；2.The Central Hospital of Luohe，Henan 462000；3.Teaching and Research Section Epidemic of Disease and Health Statistics， College of Public Health，Zhengzhou University，Zhengzhou 450001 [Abstract] Objective To focus primarily on comparing the myocardial protective effect of Histidine-Tryptophan-Ketoglutarate（HTK）cardioplegia with cold crystalloid cardioplegia and cold blood cardioplegia in infant open heart surgery，to explore the most suitable myocardial protective measures for infants and young children. Methods 60 infants with congenital heart disease were randomized into three groups. After cardiopulmonary bypass was instituted，and then the ascending aorta was clamped. Serum levels of endothelin-1（ET-l）， creatine kinase（CK），creatine kinase MB（CK-MB），and cardiac troponin T（cTnT） were measured. The data was analyzed by SAS9.13 statistical software. Results Before ischemia， cardiac function and leakage of myocardial enzyme were comparable in three groups with no significant difference（P＞0.05）. After ischemia auto- beating ratio in group A were significantly lower than those in group B and C. ET-1，CK，CK-MB and cTnT leakage in group A were significantly lower than those in group B and C（P＜0.05）. Conclusion In the period of aortic cross-clamping， after perfusion HTK cardioplegia one-time，the effect of ca