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目的研究体外循环中全心缺血再灌注损伤时心肌微循环的动态变化以及降钙素基因相关肽（ＣＧＲＰ）的心肌保护作用。方法建立猪体外循环心肌缺血再灌注模型，应用激光多普勒微循环血流计，分别于体外循环不同时间点，观测右心耳同一部位的心肌微区灌流量，并同时记录心率和血压；以ＣＧＲＰ作为心肌麻痹液的组成部分，观察其对心肌微区灌流量变化的影响。结果心肌微区灌流量在体外循环开始后与体外循环前相比无统计学差别。再灌注后，心肌微区灌流量显著降低，随再灌注时间的延长逐渐上升至缺血前水平。应用ＣＧＲＰ组在再灌注各时间点的心肌微区灌流量均较对照组明显增高，其变化早于血压的升高，并与心率的变化无关。结论体外循环心脏再灌注后存在心肌微循环障碍，ＣＧＲＰ作为心肌麻痹液的组成部分可改善体外循环心肌再灌注后心脏的微循环功能，从而起到心肌保护作用。
Objective To study the dynamic changes of myocardial microcirculation and myocardial protection of calcitonin gene related peptide (CGRP) during cardiopulmonary bypass (I / R) injury. Methods Myocardial ischemia - reperfusion model was established in pigs during cardiopulmonary bypass. The perfusion of myocardium in the same site of right atrial appendage was observed at different time points after cardiopulmonary bypass. The heart rate and blood pressure were also recorded. To CGRP as a component of myocardial paralysis fluid, to observe the myocardial microperfusion perfusion changes. Results Myocardial micro-perfusion in vitro after cardiopulmonary bypass compared with before cardiopulmonary bypass was no significant difference. After reperfusion, myocardial perfusion decreased significantly, with the reperfusion time gradually increased to pre-ischemic level. In the CGRP group, the perfusion of myocardial microvessels at each time point of reperfusion was significantly higher than that of the control group, and its change was earlier than the increase of blood pressure, and had no relation with the change of heart rate. Conclusions Myocardial microcirculation disturbance exists after cardiopulmonary reperfusion in cardiopulmonary bypass. CGRP, as a component of cardioplegia, can improve the microcirculation function of cardiopulmonary bypass after cardiopulmonary reperfusion and thus play a role in myocardial protection.