自体冷血心脏停搏液对未成熟心肌细胞ATP及三磷酸腺苷酶的影响

The Effect of Cold Autologous Blood Cardioplegic Solution to ATP Contents and ATPase Activities of Immature Cardiocyte

目的：通过对比自体冷血心脏停搏液与HTK液对未成熟心肌细胞ATP含量及三磷酸腺苷酶（ATPase）活性的影响，提示自体冷血心脏停搏液对未成熟心肌细胞的保护作用。方法：年龄≤1岁行体外循环室间隔缺损修补术的患儿40例随机分为2组，实验组20捌、对照组20例。主动脉阻断后，分别用自体冷血停搏液、HTK液根部灌注。于心脏停跳前、复跳后30min取右心耳标本50mg，测定心肌ATP含量及ATPase活性。运用统计学t检验的方法，得出研究结果。结果：主动脉阻断前两组患儿心肌ATP含量（btg／mg）与Na＋-K＋-ATPase、Ca2＋-ATPase、Ca2＋-Mg2＋-～AT-Pase活性（umol／mgoh）无统计学差异（P〉0．05）；主动脉开放后30min心肌ATP含量与ATPase活性均较阻断前显著减少（P〈0．01）；主动脉开放后30min两组患儿心肌ATP含量与ATPase活性有明显差异（P〈0．01）；对照组主动脉开放后30min心肌ATP的损耗量明显较实验组增多（P〈0．01）。结论：自体冷血停搏液可提升体外循环G内直视手术术后未成熟心肌细胞ATP含量及ATPase活性，对未成熟心肌的心肌保护效果明显优于HTK液。

Objective; Contrasting ATP contents and ATPase activities of immature cadiocytes affected by autologous blood cardioplegic solution and HTK solution, is to demonstrate its protective effect on the immature cadiocytes. Methods： 40 children of age under 1--year--old with repair of ven- tricular septal defect in cardiopulmonary bypass were included and randomly grouped into two units： ＂cold autologous blood cardioplegia＂ （n=20 ; Experimerit Group） and ＂HTK solution＂ （n= 20; Control Group）. ATP contents and ATPase activities of Right atrial appendage were measured prior to asystole （Time 1） and 30 minutes after re--beating （Time 2）, with each of （50mg） of the specimens being extracted respectively. By studying the differences in the two groups of indicators, results are obtained by the use of statistical t test method. Results： At Time 1, ATP contents （μg/mg） and Na＋ --K＋ --ATPase, Ca2＋ --ATPase, Ca2＋ --Mg2＋ --ATPase activities （μmol/mgoh） of cadiocytes in two groups have not statistical difference （ P〉 0.05）. While at Time 2, the difference become significant （ P 〈0.01）. The contents and activities decrease significantly at Time 2 in both groups （ P d0.01）. The reduction Of ATP contents is increased after the aorta unclamping in control group （ P〈0.01）. Conclusion.. ATP contents and ATPase activities of immature cadiocytes are increased after applying autologous blood cardioplegic solution undergoing open heart operation. Immature cadiocytes is protected significantly by autologous blood cardioplegie solution rather than HTK solution.