心脏直视手术外源性磷酸肌酸的心肌保护效果

目的：观察外源性磷酸肌酸（ＣＰ）用于心肌保护液，对心脏直视手术缺血期间的心肌保护作用。方法：９８例病人分为对照组４４例，ＣＰ组５４例。观察两组病人心脏自动复跳情况、术后４８小时内５种心肌酶的动态变化及心肌超微结构的改变。结果：两组病人自动复跳率比较，ＣＰ组高于对照组；５种心肌酶变化趋势显示对照组心肌酶释放峰值高于ＣＰ组，下降缓于ＣＰ组。电镜检查ＣＰ组保存了较好的超微结构。结论：外源性磷酸肌酸用于心肌保护液，有明显的心肌保护效果。

Clinical Study of the Protective Effect of Exogenous Creatine Phosphate on Ischemic Myocardium during Open Heart Surgery

Aim:This study was designed to evaluate the myocardial protective effect of exogenous creatine phosphate (CP) added into cardioplegic solution used during open heart surgery.Method:98 patients were divided into control group (n=44) and CP group (n=54).The spontaneous recovery rate,of heart beats aftre cardiac resuscitation was recorded and changes of serum enzames including CPK,LDH,CPK MB,HBDH and AST were determined.The ultrastructures alteration of the myocardial tissue were observed in some of the cases having valvular replacement.Results:The spontaneous recovery rate of heart beats in CP group was significantly higher than the control group.In the control group,the peak values of leakage of serum enzymes appeared earlier and receded later than those in the CP group.Electron microscopic examination revealed better preservation of the ultrastructures of the myocardial tissue from CP group than in the control group.Conclusion:The data indicates that exogenous creatine phosphate added to the cardioplegic solution offers better protective effect on the ischemic myocardium during open surgery.