尼莫地平对法洛四联症患儿心肌细胞内钙运转及心功能的影响

Effects of calcium agonist nimodipine on myocardial calcium transport and cardiac function of tetralogy of Fallot children.

目的 研究尼莫地平对法洛四联症（ＴＯＦ）患儿心肌细胞钙转运和心功能的影响。方法 ２７ 例ＴＯＦ分为对照组（１２例）和治疗组〔１５ 例，尼莫地平１．０～１．５ｍ ｇ／（ｋｇ·ｄ）×１４ｄ〕。测定治疗前后心肌细胞内外钙浓度和心功能。结果 用尼莫地平后治疗组红细胞游离钙和总钙浓度明显降低，钠泵活性升高，而钙泵活性无变化；心肌细胞游离钙（２０４±３３ｎｍ ｏｌ／Ｌ）较对照组（３４７±８５ｎｍ ｏｌ／Ｌ）明显降低（Ｐ＜ ０．０１）；心肌细胞线粒体和内质网肿胀明显减轻或消失，线粒体密度升高；心脏指数和左右心室充盈功能明显改善。结论 尼莫地平可明显减轻ＴＯＦ患儿心肌细胞内外的钙超载。

Objective To study the effect of nimodipine on myocardial calcium transport and cardiac function of tetralogy of Fallot(TOF)children. Methods 27 TOF children were divided into two groups:control group(12 cases) and study group〔15 cases,nimodipine 1.0~ 1.5 mg/(kg·d)〕.The concentration intra and extracellular calcium of myocardial cells and cardiac function was measured before and after treatment. Results After nimodipine therapy,the concentration of ionized and total calcium of erythrocyte decreased significantly,the activities of natrium pump increased significantly but no obvious changes occurred to the activities of calcium pump.After administration,the concentrations of ionized calcium of myocardial cells(204±33nmol/L)decreased significantly as compared with those of control group(347±85nmol/L, P <0.01);the edema of mitochondria and sarcoplasmic reticulum alleviated or disappeared and the density of mitochondria increased;the cardiac index and the filling function of right and left ventricle increased significantly in study group. Conclusion The calcium overload of intra and extracellular of myocardial cells was alleviated markedly after nimodipine therapy in TOF children,and meanwhile its cardiac function was also improved.