体外循环中磷酸肌酸对未成熟心肌的保护作用

来源 :第四军医大学学报 | 被引量 : 0次 | 上传用户:jianxiaxjb
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目的 研究人未成熟心肌在心肌停跳条件下高能化合物耗竭情况及磷酸肌酸 ( CP)对于未成熟心肌能量代谢的影响 .方法 先心病患儿 18例按体质量、性别、年龄相近似配成 9对 ,对每组中两个个体随机分配给两种处理 , 组为本院使用的改良停搏液 , 组改良停搏液加磷酸肌酸 10 m L .L- 1 ,分别于心肌缺血前后取右心耳心肌组织 HPL C测定心肌能量物质 CP,ATP,ADP及 AMP.结果 两组术前 L A,CK- MB水平无显著差异 ,而比较缺血未复灌 10 ,30 ,5 0 min发现 组L A,CK- MB漏出量均较少 ( P<0 .0 5 ) .两组术前心肌各能量物质 ( ATP,ADP,AMP,CP)水平相似 ;在缺血再灌注后心肌各能量物质 ( ATP,ADP,AMP,CP) 组 ATP,AMP,CP含量均明显高于 组 ,ATP ( 0 .1983 m mol.g- 1 ,0 .10 36 mmol.g- 1 ,P=0 .0 0 8) ,AMP( 0 .10 82 mmol.g- 1 ,0 .0 5 72 mmol.g- 1 ,P=0 .0 11) ,CP( 0 .4974mmol.g- 1 ,0 .3743mmol.g- 1 ,P=0 .0 0 5 )总非扩散核苷酸 TNN* (除 IMP) ( 0 .46 0 9mmol.g- 1 ,0 .2 90 4mmol.g- 1 )的恢复均优于 组 ,但是两组 ADP( 0 .15 98mmol.g- 1 ,0 .12 96 mmol.g- 1 ,P=0 .345 )无差异 . 组超微结构明显优于 组 .结论 目前心肌保护条件下加入 CP对于未成熟心肌能量物质保存有一定意义 ,即通过减少高能磷? Objective To study the depletion of high-energy compounds in immature myocardium under cardiomyocyte arrest and the effect of creatine phosphate (CP) on the energy metabolism of immature myocardium.Methods 18 cases of children with congenital heart disease were matched according to body weight, sex and age 9 pairs of two individuals in each group were randomly assigned to two treatments, the group used for the improvement of cardioplegia solution, the group of modified cardioplegia with creatine phosphate 10 m L. L-1, respectively, in myocardial ischemia Before and after taking the right atrial appendage myocardial tissue HPL C determination of myocardial energy substances CP, ATP, ADP and AMP.Results The preoperative LA, CK-MB levels were no significant difference, but compared with ischemic reperfusion 10,30, 50 min found The levels of LA, CK-MB in the two groups were all less than those in the control group (P <0.05) .The levels of ATP, ADP, AMP, CP in the two groups were similar before and after myocardial ischemia / reperfusion (ATP, ADP, AMP, CP), the content of ATP, AMP and CP were significantly higher than that of the control group (P <0.01) 8), AMP (0.1082 mmol.g-1,0.572 mmol.g-1, P = 0.011), CP (0.4974 mmol.g-1, 0.3743 mmol.g- 1, P = 0. 0 0 5) Total non-proliferation nucleotides TNN * (except IMP) (0 .46 0 9mmol.g- 1, 0. 2 90 4mmol.g- 1) were better than the group, but two groups of ADP (0.1598mmol.g- 1, 0.1296mmol.g- 1, P = 0 .345) .There was no difference in the ultrastructure of the group.Conclusion The current CP protection under myocardial protection has certain significance for the preservation of immature myocardial energy substances, that is, by reducing the high-energy phosphorus?
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