顺／逆行同时心肌灌注对于细胞容量和能量代谢影响的研究临床医学.docVIP

顺／逆行同时心肌灌注对于细胞容量和能量代谢影响的研究临床医学 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：顺／逆行同时心肌灌注对于细胞容量和能量代谢影响的研究临床医学 1 1 材料和方法 3 2 结 果 4 3 讨 论 5 文2：妊娠期糖尿病治疗对妊娠结局影响的研究临床医学 6 1 资料与方法 6 2 结果 8 3 讨论 9 参考文摘引言： 10 原创性声明（模板） 12 文章致谢（模板） 12 正文 顺／逆行同时心肌灌注对于细胞容量和能量代谢影响的研究临床医学 文1：顺／逆行同时心肌灌注对于细胞容量和能量代谢影响的研究临床医学 Abstract: OBJECTIVE To assess the effects of simultaneous antegradeetrograde cardioplegia (SARC) on cellular volumes and energy metabolism using magnetic resonance spectroscopy. METHODS Ten isolated pig hearts were perfused for 2 hou through aorta and coronary sinus simultaneously with blood cardioplegia. Myocardial water content was monitored continuously throughout SARC using near infrared (NIR) spectroscopy. Phosphorus-31 magnetic resonance spectroscopy (31P M) in conjuction with 31P M-detectable marke, dimethyl methylphosphonate (DMMP) and phenylphosphonate (PPA), were used to follow the volumes of both intra- and extracellular compartments and to assess myocardial energy metabolism during SARC. DMMP distributes to the entire water space while PPA accesses only to the extra-cellular compartment. RESULTS NIR spectra showed a significant increase (160±12% to the initial value 100%) in water content during SARC, indicating tissue MR spectra obtained during SARC showed a gradual and significant increase in both DMMP and PPA peaks. At the end of 2-hour SARC, the intra- and extra-cellular compartments increased to 136±4% and 154±8%, respectively, relative to their initial volumes (100%). However, myocardial energy metabolites remained relatively unchanged during 2-hour SARC. CONCLUSION 2-hour SARC results in severe expaion of both intra- and extra-cellular compartments. Edematous myocardium can maintain normal energy metabolism during 2-hour SARC. Key words： Magnetic resonance；Spectroscopy;Cardioplegia；Myocardial Edema；Energy Metabolism;Perfusion 理想的心肌保护应该向心脏的各个部分均提供充足灌注［1-2］。单纯顺行或逆行灌注都存在着灌注不均匀的缺陷，因此人们建议将两种方式结合起来，进行顺／逆行同时灌注（SARC）［3-5］。但是SARC能否引起组织水肿，从而影