含氧血及冷晶体心脏停搏液灌注后线粒体量化计分及超微结构变化的比较研究

目的 :对比研究含氧血心脏停搏液连续灌注与冷晶体心脏停搏液间断灌注后心肌线粒体量化计分及超微结构的变化。方法 :患者分为三组 (每组 8例 )。主动脉阻塞前及再灌注后 2 0～ 30分钟各取 1m m3心室壁肌肉置入 4℃ 2 %戊二醛液中固定。在电镜下选择 5个视野 ,每个视野随机观察 2 0个线粒体。依受损程度分为 0～ 4级 ,将 10 0个线粒体按级得分总和除以 10 0即为该组得分数。结果 :再灌注 2 0～ 30分钟后冷晶组计分为 (2 .6 92± 0 .46 2 ) (P<0 .0 5 ) ;浅低温血组计分为 (1.0 6 7±0 .377) ;常温血组计分为 (1.16 5± 0 .30 2 )。结论 :电镜下线粒体超微结构及量化计分证明了含氧血组心肌保护明显优于冷晶组。

A comparative electron microscopic study of mitochondria scoring and ultrastructural changes of myocardium on oxygenated blood and cold crystalloid cardioplegia perfusion

Objective: The study carried out to study the cardiac protection effect with the mitochondria Scoring and Ultrastructural Changes between continuous oxygenated blood cardioplegia perfusion and intermittent cold crystalloid cardioplegia perfusion. Methods: 24 patients was divided into three groups (8 patients in each groups). Ahead aorta was clamped and 20~30 minutes after reperfusion, a piece of myocardium was obtained, and fixed in 2% distilled glutardehyde at 4℃。 They were observed under electron microscope. According to Flameng method, every mitochondria was graded on score 0~4 scale semiquantatively. Average score of 100 mitochondria per sample was calculated. Results: Mitochondria score of CCC group was much higher than LBC and WBC group〔(2.692±0.462) vs (1.067±0.377), (1.165±0.302), P <0.05 at 20~30 minutes after reperfusion〕. The ultrastructural lesion of myocardium was more serious in CCC than ones in LBC and WBC. Conclusion: The results of this study indicate that continuous oxygenated blood cardioplegia is superior to intermittent cold crystalloid cardioplegia in myocardial protection.