心肌酶谱对血停跳液心肌保护作用的评价

Study on CPK、CK-MB、AST and LDH with Blood Cardioplegia Preservation.

在５２例复杂先心病心内矫正术中，应用血停跳液（ＢＣＰ）加强心肌保护，与晶体停跳液（ＣＣＰ）进行比较。记录术前、术后６、１２、２４、４８、７２小时内ＣＰＫ、ＣＫ－ＭＢ、ＡＳＴ、ＬＤＨ的变化。结果显示５：术后７２小时内，ＢＣＰ组ＣＫ－ＭＢ值均低于ＣＣＰ组，其峰值只是ＣＣＰ组的５９．８％（Ｐ＜０．０５），酶的释出量大为减少，并于７２小时降至正常，恢复比ＣＣＰ组早；ＣＰＫ、ＡＳＴ、ＬＤＨ值均显示较ＣＣＰ组低。血停跳液能增加心肌能量储备，提高心肌抗缺血的能力，减轻心肌损伤的程度，在加强复杂先心病的心肌保护中，显示出显著的效果。ＢＣＰ心肌保护的效果优于ＣＣＰ。

This paper reported the study on myocardial protection during open heart surgery in 52 cases of complex congenital heart disease.Twenty-six cases received blood cardioplegia(BCP) and twenty-six received crystalloid cardioplegia(CCP).Release of serum enzymes(CPK,CK-MB,AST and LDH) was determined preoperatively and at 6、12、24、48 and 72 postoperative hours.During the first 72 postoperative hours,level of CJK - MB in BCP group is lower than that in CCP group.In CCP group,CK-MB level increased significantly even 72 hours after operation.The value of CPK,AST and LDH in CCP group was higher than that in BCP group. The results show BCP can maintain metabolic balance of myocardium, reduce myocardial injury and increase myocardial high energy phosphates contents during ischemia and can provide a better result in myocardial protection.