间断温血灌注心肌保护作用的实验研究

Experiment Study of Myoccardial Protection by Intermittent Warm Blood Cardioplegia

目的研究间断温血灌注的心肌保护效果.方法21只孤立灌注的犬心随机分为3组.Ⅰ组行持续温血灌注;Ⅱ组行间断温血灌注,间歇缺血期为10 min;Ⅲ组行间断温血灌注,间歇缺血期为15 min.结果灌注2 h,3 h后,心肌超微结构改变,冠状静脉窦回流血血清肌酸磷酸激酶(CPK-MB)含量的变化,Ⅰ、Ⅱ2组组内、组间均无明显差异(P＞0.05),Ⅲ组组内与Ⅰ、Ⅱ组组间差异显著(P＜0.01).结论间断温血灌注,间歇缺血期时限适当,心肌没有明显累积性不良影响,与持续温血灌注具有相同的心肌保护效果.间歇缺血期最高时限,定为10min较安全.

Objective To assess the effects of myocardial protection by intermittent warm blood cardioplegia(IWBC).Methods 21 isolated dogs'hearts perfused by warm blood were divided into three groups randomly.In group Ⅰ,the dogs'hearts ( n =7) received the continuous warm blood cardioplegia(CWBC);In group Ⅱ,the dogs'hearts ( n =7) received 5 minute warm blood cardiaplegia ,which were interrupted by 10 minute ischemia;In group Ⅲ,the dogs'hearts ( n =7) were interrupted by 15 minute ischemia.Results After clamping of the aorta by 2 hours and 3 hours, both in the score of the ultrastructural changes of tissue samples and the CPK MB content, there were no significant differences between the groupⅠ andⅡ( P >0 05).The difference was significant between the group Ⅲ and groupⅠ,Ⅱ ( P <0.01).Conclusion No obvious cumulative harmful effects on myocardium by IWBC with 10 minute intermission within 3 hours. IWBC with 10 minute intermission may provide as much myocardial protection as does CWBC within 3 hours. It was safer that the maximum of the intermission was 10 minutes.