自体冷血心脏停搏液对未成熟心肌细胞三磷酸腺苷及二磷酸腺苷的影响

The effect of cold autologous blood cardioplegic solution to ATP & ADP contents of immature cardiocyte

目的通过对比自体冷血心脏停搏液与含血停搏液、St.Thomas液、HTK液对未成熟心肌细胞三磷酸腺苷(ATP)及二磷酸腺苷(ADP)含量的影响,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≤12个月行体外循环室间隔缺损修补术的患儿80例,随机分成自体冷血停搏液组(A组)、冷血停搏液组(B组)、St.Thomas液组(C组)和HTK液组(D组),每组各20例。于主动脉阻断前、主动脉开放后30 min取右心耳标本50 mg,用HPLC法测定心肌ATP、ADP含量。结果主动脉阻断前各组患儿心肌ATP与ADP含量无统计学差异(P>0.05);各组患儿主动脉开放后30 min心肌ATP与ADP含量均较阻断前显著减少(P<0.01);A组患儿主动脉开放后30 min心肌ATP与ADP含量较B组显著增高(P<0.01)。结论自体冷血停搏液可显著提升体外循环心内直视手术术后未成熟心肌细胞ATP含量,效果明显优于含血停搏液、St.Thomas液以及HTK液。

OBJECTIVE To compare with ATP ADP contents of immature cadiocytes affected by 4 kind of cardioplegic solutions（cold autologous blood cardioplegic solution,cold blood cardioplegic solution,St.Thomas solution and HTK solution）,and show the protective effect on the immature cadiocytes.METHODS 80 children of age under 1-year-old underwent ventricular septal defect repair operaton with cardiopulmonary bypass were randomly divided into 4 groups according to the difference of cardioplegic solution： cold autologous blood cardioplegia group（n=20;Group A）;cold blood cardioplegia group（n=20;Group B）;St.Thomas solution group（n=20;Group C） and HTK solution group（n=20;Group D）.ATP ADP contents of right atrial appendage（50 mg） were measured by high performance liquid chromatography（HPLC） prior to the aorta clamped（Time 1） and 30 minutes after the aorta unclamping（Time 2） respectively.RESULTS At Time 1,ATP ADP contents of cadiocytes in 4 groups have not statistical difference（P〉0.05）.The contents decrease significantly at Time 2 in 4 groups（P〈0.01）.ATP ADP contents are increased at Time 2 in Group A than others（P〈0.01）.CONCLUSION ATP contents of immature cadiocytes are increased after applying autologous blood cardioplegic solution undergoing open heart operation,rather than cold blood cardioplegic solution,St.Thomas solution and HTK solution.