摘要
目的观察温氧合血（35℃）心停搏液微流量连灌与微温氧合血（26—28℃）间灌心肌线粒体量化计分及超微结构的变化。方法选择20例择期心脏瓣膜置换术，按机械分类法随机分为两组（每组10例）。A组采用常CPB温氧合血（35℃）心停搏液微流量连灌；B组采用浅低温CPB微温氧合血（26～28℃）心停搏液间灌。分别于主动脉阻断时和再灌注30分钟各取左室壁心肌（1～2mm3），电镜观察并摄片。在电镜下选择5个视野，每个视野随机观察20个线粒体，依受损程度分为0～4级，将100个线粒体按级得分总和除以100即为该组得分数。结果两组在主动脉阻断时心肌超微结构基本正常，再灌注30分钟，A组得分（1．2346±0．2621），B组得分（1．1632±0．2153），两组间比较无显著性差异（P〉0．05）。结论在瓣膜置换术中两组含血心停搏液的心肌保护作用近似，微温血心停搏液具有更好的心肌保护作用。
Objective The study carried out to study the cardiac protection effect with the mitochondria sooting and ultrastructural changes between continuous warm oxygenated blood cardioplegia （ 35 ℃ ）minimum-flow penfusion and intemittent antegrade tepid oxy- genated blood cardioplegia （26-28 ℃ ） perfusion. Methods 20 patients undergoing valve replacement was divided into two groups （ 10 patients each groups;） （1） continuous warm oxygenated blood cardioplegia（n=10） and （2） intermittent antegrade tepid oxygenated blood cardioplegia （n=10）. Ahead aorta was clamped and 30 minutes after reperfusion, a piece of myocardium was obtained, and fixed in 2.5% distilled glutardehvde for 2 hours, at 4℃.They were observed under eletron microscope According to Flameng method, every mitoehondria was graded on score 0-4 scale sem iguantatively. A verage score of 100 mitochondria per sample was calculated. Results： uhrastructure of the myecardium were not significanly different between two groups before the aortic cross-clamping, mitoehondria score of A group, （1.2346 ± 0.2621）,and B gorup,（1.632 ± 0.2153） P 〉 0.05 at 30 minutes after reperfusion .Conclusion：During cardiac valve replacement tow groups blood carolioplegia has a similar effect on myocardial protection. Intermittent antegrade tepid blood eardioplegia is superior to contuuous warm blood cardiopleaia of myocardial protection.
