去白细胞冷自体血停搏液对体外循环未成熟心肌的保护作用

Effects of leucocyte-filtrated cold self-blood cardioplegia on immature myocardial protection in infant underwent opening heart operation with cardiopulmonary bypass

目的探讨去白细胞冷自体血停搏液对体外循环未成熟心肌的保护作用。方法 100例年龄≤10个月、体质量≤8 kg的患儿按随机数字表法随机分为去白细胞冷自体血停搏液组(实验组)和冷自体血停搏液组(对照组)。分别于体外循环前及主动脉开放后10 min检测心肌组织中超氧化物歧化酶(superoxide dismutase,SOD)、髓过氧化物酶(myeloperoxidase enzyme,MPO)及丙二醛(malondialdehyde,MDA)的浓度。结果主动脉开放10 min时实验组SOD[(58.39±3.96)U/L vs.(39.46±3.32)U/L,P<0.05]高于对照组,MPO[(30.73±7.28)U/10 g vs.(35.75±5.33)U/10 g,P<0.05]及MDA[(1.88±0.10)mmol/L vs.(3.55±0.23)mmol/L,P<0.05]低于对照组,心脏复搏时间[(35.73±3.05)s vs.(46.56±5.56)s,P<0.01]及机械通气时间[(7.40±2.53)h vs.(9.46±1.70)h,P<0.05]低于对照组,差异有统计学意义。结论冷自体血停搏液滤除白细胞对体外循环心脏直视手术中未成熟心肌更具保护作用。

Objectives To observe the effect of leucocyte-filtrated cold self-blood cardioplegia on immature myocardialprotection in infant underwent opening heart operation under cardiopulmonary bypass（CPB）. Methods One hundredinfantile patients were randomly divided into two groups. Fifty four cases were given leucocyte-filtrated cold self-bloodcardioplegia as treatment group,while 46 cases were given cold self-blood cardioplegia without leucocyte filtration ascontrol group. Concentrations of superoxide dismutase（SOD）,myeloperoxidase enzyme（MPO）and malondialdehyde（MDA） in myocardial tissue were examined before CPB and 10 minutes after removing the aorta cross-clamp.Results Ten minutes after removing the aorta cross-clamp,concentration of SOD in myocardial tissue in treatmentgroup was significantly higher than that of control group[（58.39±3.96）U/L vs.（39.46±3.32）U/L,P〈0.05],whileconcentrations of MPO[（30.73±7.28）U/10 g vs.（35.75±5.33）U/10 g,P〈0.05]and MDA[（1.88±0.10）mmol/L vs.（3.55±0.23）mmol/L,P〈0.05]were significantly lower. The heart re-beating time[（35.73±3.05）s vs.（46.56±5.56）s,P〈0.01]and duration of mechanical ventilation[（7.40±2.53）h vs.（9.46±1.70）h,P〈0.05]were shorter in treatmentgroup than in control group. Conclusions The leucocyte-filtrated cold self-blood cardioplegia is effective in protectingimmature myocardium in infant underwent opening heart operation under CPB.