冠状静脉窦堵塞增加主动脉灌注心肌保护的效果

Coronary sinus occlusion enhances theprotective effect of aortic cardioplegia on themyocardium

本研究观察了冠状静脉窦堵塞（ＣＳＯ）在有冠状动脉梗阻时增加冷停搏液主动脉灌注（ＡＰ）对１ｈ缺血心肌的保护效果，结果表明，缺血复灌后，ＣＳＯ组左右心功能恢复明显改善，心电图正常，线粒体内有氧代谢标志酶——琥珀酸脱氢酶（ＳＤＨ）活性较高（＋＋＋＋）。ＡＰ组左右心功能恢复明显降低，心电图示Ｓ—Ｔ段抬高，ＳＤＨ活性明显降低（＋）。由此可见，存在冠状动脉梗阻时，ＡＰ不能有效地防止心肌缺血复灌损伤，而ＣＳＯ明显促进心肌内冷停搏液均匀分布，增加ＡＰ保护缺血心肌的效果。

Thi article has demonstrated that coro-nary sinus occlusion(CSO) improves protec-tive effects of aortic perfusion(AP)on l h is-chemic myocardium in the presence of an ob-structed coronary artery。Results showed thatafter reperfusion in CSO,recovery of perfor-mance of the left and right ventricle was sig-nificantly increased,electrocardiogram pre-sented normally,and activity of succinate de-hydrogenase(SDH)involved in aerobicmetabolism in the mitochondria was muchhigher(++++).On the other hand,cardiacfunction was obviously reduced,S-T segmentswere elevated and SDH activity was markedlydepressed(+)in AP.It suggested that APcould not prevent myocardial ischemic reperfu-sion injury when coronary arteries were oc-cluded.CSO improved homogeneous distribu-tion of cardioplegia significantly and enhancedthe effect of AP on preservation of ischemicmyocardium。