外源性磷酸肌酸对未成熟心肌的保护作用

Immature Myocardial Protective Function of Creatine Phosphate

目的 观察外源性磷酸肌酸 (CP)对缺血未成熟心肌的保护作用。 方法 将 2 0例法洛四联症 (TOF)、室间隔缺损 (VSD)患者分为两组 ,对照组 :术中应用冷晶体心肌保护液 ;CP组 :应用 10 mmol/L CP强化冷晶体心肌保护液。观察两组患者心脏电生理指标、血流动力学恢复、正性肌力药物用量、心肌细胞超微结构和心肌酶浓度变化等。 结果 CP组恢复窦性心律所需时间和正性肌力药物用量显著低于对照组 (P<0 .0 5 ) ;电子显微镜下 ,CP组超微结构保存较好 ,损伤比对照组小。 结论 CP增强了冷晶体心肌保护液对未成熟心肌的保护作用。

Objective To study the potential for enhancing ischemic immature myocardial protection by adding creatine phosphate (CP) to crystal cardioplegic solutions. Methods Twenty infant patients with tetralogy of Fallot (TOF) and ventricular septal defect (VSD) underwent operations on cardiopulmonary bypass. They were divided into either a control group, who received crystal cardioplegic solutions, or a CP group, receiving the same cardioplegic solution with CP (10 mmol/L). Cardiac electrophysiologic data, recovery of hemodynamics, inotropic medicine dosage, myocardial ultrastructural changes and concentration of myocardial enzymes were assessed. Results The time of restoration of spontaneous sinus rhythm in the CP group decreased significantly ( P <0.05), inotropic medicine dosage in the CP group was much lower than that in the control group( P <0.05). The myocardial ultrastructure in CP group was less damaged than that in the control group. Conclusion CP enhances immature myocardial protection of crystal cardioplegic solutions.