体外循环术中去白细胞常温血心脏停搏液灌注对心肌的保护作用

目的 :研究体外循环术中去白细胞常温血心脏停搏液微流量连续灌注对心肌的保护作用。方法 :临床随机选择主动脉 (AO)阻断时间在 60min以上的心脏瓣膜置换患者 2 0例。随机分为试验组和对照组 ,每组 1 0例 ,检测术中不同时间点脂肪酸结合蛋白 (HH FABP)水平和右心房心肌内髓过氧化物酶 (MPO)含量。结果 :①试验组AO开放后 2 0min ,40min ,60min血清HH FABP均较AO阻断前及开放即刻升高 (P <0 .0 1或P <0 .0 5) ,且含量均明显低于对照组 (P <0 .0 1 )。②试验组AO开放即刻及开放后 2 0min心房心肌内MPO与阻断前相比无明显增加 ,而对照组与阻断前相比明显增加 (P <0 .0 1 ) ,2组之间比较 ,差异有统计学意义 (P <0 .0 1 )。HH FABP与AO阻断时间呈正相关 ,试验组r=0 .962 4 ,P <0 .0 1 ,对照组r=0 .70 31 ,P <0 .0 5。结论 :去白细胞常温血心脏停搏液微流量连续灌注可减轻心肌缺血 再灌损伤 ,有利于心肌保护

Effects of warm oxygenated leukocyte-depleted blood cardioplegia micro-dose continuous perfusion during cardiac valve replacement

Aim:To investigate the protective effects on myocardia by warm oxygenated leukocyte depleted blood cardioplegia microdose continuous perfusion during cardiac valve replacement.Methods:Twenty patients who received cardiac valve replacement operations with the aortic crossclamping time more than 40 minutes were selected. They were randomly allocated into two groups:experiment group and control group (ten patients in each group). The serum levels of human heart fatty acid binding protein (HH FABP) and myeloperoxidase(MPO) of the right atrium myocardium at different time points were detected. Results: The serum HH FABP levels of the two groups at different time points after aortic declamping were higher than those before operation, and the serum levels of HH FABP in experiment group were lower than those in control group at 5 min, 15 min, and 30 min after aortic declamping; after declamping,there was no changes in MPO contents in experiment group at different time points but great increases in control group. Conclusion: Warm oxygenated leukocyte depleted blood cardioplegia microdose continuous perfusion can relieve myocardium ischemia reperfusion injury.