摘要
目的 研究原位猪心移植中,不同灌注方式的心肌保护效果。方法 将24对家养猪随机分为两组:冷血组(n=12对),采用4℃含氧合血心脏停跳液间断灌注;温血组(n=12对),用36℃含氧合血停跳液诱导心脏停跳,冷血维持,终末温血灌注保护心肌。分别于心肺转流(CPB)前(T_1)、开放升主动脉后30min(T_2)、60min(T_3)、停机时(T_4)抽取中心静脉血,离心后测定两组血浆心肌肌钙蛋白T(cTnT)、内皮素-1(ET-1)、丙二醛(MDA)、超氧化物歧化酶(SOD)浓度和心脏复跳后的血液动力学指标。结果 CPB后,冷血组血浆中的cTnT、ET-1、MDA较温血组明显增高,心脏复跳后血液动力学指标恢复至基础值水平,温血组优于冷血组,且SOD保持较高的活性。结论 冷温氧合血停跳液联合灌注,能够减轻心肌再灌注损伤,有利于术后心脏功能迅速恢复。
Objective To investigate the protective effect of combined infusion of cold and warm blood cardioplegic solution on the myocardium during heart transplantation of pig. Methods 24 pairs of pigs were randomly divided into two groups. Group A (n=12 pairs) was infused with cold blood cardioplegia,group B (n=12 pairs) with cold blood eardioplegia combined with warm blood cardioplegia immediately after aortic clamping and just before aortic unclamping. Venous blood samples were taken before cardiopulmonary bypass (CPB) (T_1),at 30 min and 60 min after aortic release (T_2 and T_3),immediately discontinuation of CPB (T_4) for determination of plasma levels of cTnT, ET-1, MDA,SOD. Hemodynamic parameters were observed after recovery of heart beat. Results In group A, cTnT,ET-1,MDA levels were significantly higher than those in group B. SOD activity was lower significantly in group A than that in group B. Hemodynamic parameters returned more effectively to the baseline in group B than those in group A. Conclusion combined infusion of warm and cold blood cardioplegia is more effective in reducing ischemia-reperfusion injury during heart transplantation.
出处
《临床麻醉学杂志》
CAS
CSCD
2004年第4期226-228,共3页
Journal of Clinical Anesthesiology
