用心肌酶活性评价含血停搏液对心肌的保护效应

Evaluation of Protective Effect of Cold warm Blood Cardioplegia on Myocardium by the Variation of Myocardial Enzymes

为评价含血停搏液对心肌的保护效应，按其不同灌注方式将２８只低温体外循环犬随机均分为冷晶（Ａ）、冷血（Ｂ）、温血（Ｃ）和冷温血（Ｄ）４组。于心肌缺血再灌注期不同时点抽取冠状静脉血样，测定血清乳酸脱氢酶（ＬＤＨ）、天门冬氨酸转氨酶（ＡＳＴ）、肌酸激酶（ＣＫ）活性变化。结果，在主动脉开放１５～６０ｍｉｎ各时点，Ｄ组３种血清酶活性升高程度最小，与Ａ，Ｂ，Ｃ组对应时点相比差异显著（Ｐ＜０．０５或Ｐ＜０．０１）。提示冷温血联合灌注进一步增加了能量储备，极大地减少了心肌缺血缺氧程度。

To investigate the effects of blood cardioplegia on myocardial protection, twenty eight mongrel dogs were equally divided into four groups: group A, intermittent infusion with cold crystalloid (4℃); group B, intermittent infusion with cold blood cardioplegia (10℃); group C, on the base of group A, infusion with warm blood cardioplegia (37℃) at 5 min before opening aorta clamping; group D, infusion with cold blood cardioplegia (20℃), combined with warm blood cardioplegia the same as group C. They underwent same CPB, and during ischemia and reperfusion the coronary venous blood samples were collected. The serum enzymes (LDH, AST, CK) were determined at initiating, 60 min after ischemia, and at 15, 30, 45, 60 min after reperfusion respectively. The results showed that the values of serum enzymes of group D were the lowest among the four groups during reperfusion phase (P<0.05 or 0.01). The united infusion of cold and warm blood cardioplegia can increase the contents of myocardial high energy phosphates, suggesting that it can also effectively protect the myocardial cells against the injury of ischemia and reperfusion.