自体冷血停跳液对未成熟心肌保护机制的研究

Myocardial protection of self-blood cardioplegia for neonatus with congenital heart disease

目的:研究婴幼儿心内直视手术灌注不同停跳液心肌细胞丙二醛(MDA)和超氧化物歧化酶(SOD)的变化,探讨自体冷血停跳液对婴幼儿心肌保护的作用机制。方法:婴幼儿(体重≤8 Kg)非发绀先天性心脏病30例,随机分为自体冷血(A组)、冷血(B组)和晶体(C组)停跳液组,每组10例。分别于心脏停跳前、复跳后取右心耳心肌,检测心肌MDA和SOD含量。结果:3组术后心肌细胞MDA明显升高,SOD明显降低,与术前比较差异有统计学意义(P<0.05);其中A组MDA较低,SOD较高,与B、C组比较差异有统计学意义(P<0.05)。结论:自体冷血停跳液通过降低心肌细胞氧自由基的产生对婴幼儿心内直视手术心肌具有保护作用。

Objective：To study the changes of the oxyradical in myocardium of neonatus with acyanotic congen ital heat disease in cardiopulmonary bypass by self-blood cardioplegia. Method：There were 30 cases of neonatus with acyanotic congenital heart disease, who were divided into self-cold blood cardioplegic solution group（group A,n= 10）, allograft blood cardioplegic solution group（group B,n= 10） and crystalloid cardioplegic solution group （group C,n= 10） in the study. The biopsies were taken from right atrium just before arrested and after heart selfrecovery to measure MDA and SOD. Result： Myocardial cell＇s MDA increased and SOD decreased significantly after operation in three groups compared with those before operation （P〈0. 05）. Furthermore, MDA was lower and SOD was higher in group A than those in group B or C（P〈0.05）. Conclusion： Self-cold blood cardioplegia has cardioprotective effect in pediatric cardiac surgery by reducing oxygen free radical generation.