摘要
目的:观察一体化综合性心肌保护对婴幼儿缺血再灌注心肌超微结构的改变,以评价其心肌保护效果。方法:将30例复杂先天性心脏病患儿随机分成一体化综合性心肌保护组(综合组,n=10)、冷血停搏液间断灌注组(冷血组,n=10)及冷晶体停搏液间断灌注组(冷晶组,n=10)。于心脏停跳即刻、缝合右心房切口前分别取小块右心房肌肉作光镜及电镜观察,并对线粒体、细胞核、肌纤维进行定量评估。结果:3组心肌保护均存在不同程度的损伤,冷晶体液组最重,综合组最轻。心肌超微结构评分冷血组与综合组,冷晶组与综合组,冷晶组与冷血组比较差异均有显著性意义(t=1.99～16.78,P<0.05～0.01)。结论:心肌超微结构改变,反映了心肌缺血再灌注损伤;一体化综合性心肌保护作用优于冷血停搏液和冷晶体停搏液。
AIM:To observe the myocardial ultrastructural changes in infants during warm blood cardioplegia induction and reperfusion for protection of infants' myocardium so as to evaluate the effective method of myocardial preservation. METHODS:Thirty patients with congenital heart disease were randomized into three groups:Group of warm induction and reperfusion cardioplegia(WBC group,n=10);cold blood cardioplegia(CBC group,n=10) and cold crystalloid cardioplegia(CC group,n=10).A small part of right atrium muscle was observed under light and electron microscope at the instant moment of heart arrest and before suture respectively.Meanwhile,quantitative assay was carried out on mitochondrion, nucleus and muscle fiber. RESULTS:Myocardial protection in three groups showed different damage degree: the most severe damage occurred in the CC group and the mildest in WBC group.It indicated significant difference in myocardial ultrastructure among CBC,WBC and CC groups(t=1.99-16.78,P< 0.05-0.01). CONCLUSION:Changes of myocardial ultrastructure represents myocardial ischemical reperfusion injury;integrative protection is superior to cold blood and cold crystalloid cardioplegia.
出处
《中国临床康复》
CSCD
2004年第18期3500-3501,共2页
Chinese Journal of Clinical Rehabilitation
