摘要
目的 探讨 1,6 -二磷酸果糖 (FDP)和巯甲丙脯酸 (CAP)增强心脏停搏液对缺血心肌保护的临床效果。 方法 将 6 0例患者随机分成三组。 组 :作为对照组 ,应用我院体外循环下心肌保护方法 ,即首剂应用冷钾晶体心脏停搏液 ,从第二剂量开始改用 15℃稀释氧合血灌注 ; 组 :在冷钾晶体心脏停搏液中加入 FDP(5 mmol/ L ) ; 组 :在冷钾晶体心脏停搏液中加 FDP(5 mmol/ L)和 CAP(12 .5 mg/ L)。观察血浆丙二醛 (MDA)、肌酸磷酸激酶同工酶 (CPK-MB)、血栓素 B2 (TXB2 )、6 -酮 -前列腺素 F1α(6 -酮 - PGF1α)及电子显微镜检查结果。 结果 与 组比较 , 组和 组MDA,CPK- MB明显降低 ,且 组较好地维持了 TXB2 和 6 -酮 - PGF1α二者的比例平衡。 组和 组对线粒体也有较好地保护及提高毛细血管通畅率的作用。 结论 FDP和 CAP能明显增强心脏停搏液对缺血心肌保护的效果。
Objective To study protective effects of cardioplegic solution containing fructose-1,6-diphosphate and captopril on ischemic myocardium. Methods Sixty patients were randomly divided into 3 groups. Group Ⅰ: Control group, the clinical myocardial preservation method under extracorporeal circulation in our institution was used, namely, the cardioplegic solution of initial dose was cold potassium crystal cardioplegic solution, then the cold diluted oxygerated blood was given in the beginning from second dose. Group Ⅱ: 5mmol/L fructose-1,6-diphosphate were added to the cold potassium crystal cardioplegic solution. Group Ⅲ: 5mmol/L fructose-1,6-diphosphate and 12.5mg/L captopril were added to the cold potassium cardioplegic solution. The levels of malondialdehyde, creatine phospokinase MB, thromboxane B and 6-keto-prostaglandin F 1α in plasma were measured. Quantitative study of the myocardial ultrastructure were also undertaken. Results Creatine phospokinase MB and malondialdehyde remarkably lower in both group Ⅱ and group Ⅲ than that in group Ⅰ; the well proportion of thromboxane B and 6-keto-prostaglandin F 1α was maintained too in group Ⅲ; the function of mitochondria were effectively protected and the patent rate of capillaries was significantly increased in group Ⅱ and group Ⅲ. Conclusion Fructose-1,6-diphosphate and captopril could significantly strengthen the protective effects of cardioplegic solution on ischemic myocardium.
出处
《中国胸心血管外科临床杂志》
CAS
2001年第2期89-91,共3页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
