腺苷在婴幼儿体外循环心脏术中心肌保护作用的研究

目的观察腺苷用于婴幼儿体外循环心脏术中的心肌保护效果。方法 40例婴幼儿心脏手术患者随机分为两组,每组20例,分别为对照组、实验组。对照组术中应用安贞Ⅰ号心脏停搏液,实验组应用含腺苷1 mmol/L的安贞Ⅰ号心脏停搏液。测定围术期血浆肌钙蛋白I(cTnI)、肌酸激酶同功酶(CKMB)水平,心肌超微结构的改变,临床观察心脏停搏耗时、自动复跳率、术后多巴胺用量、气管插管时间、ICU滞留时间。结果 ICU 1 h,对照组cTnI高于实验组(P<0.05);超微结构观察对照组心肌损伤程度较实验组重;对照组心脏停搏耗时长于实验组(P<0.05)。

The clinical study on the myocardial protective effect of adenosine in infant open heart surgery

Objective To investigate the myocardial protective effect of adenosine in infant open heart surgery. MethodsForty infants with congenital heart disease for surgical therapy in cardiopulmonary bypass were included and randomly grouped into two groups： control group （n =20） and adenosine cardioplegia group （experiment group） （n =20）. Plasma levels of cardiac Troponin I （cTnI） and Creatine kinase MB （CK - MB） were measured perioperatively. Biopsies of right atrium were taken and analyzed under e- lectron microscope. Arrest time, spontaneous resuscitation rate, the requirement for inotropics, intubation time and ICU stay time were also evaluated. Results Control group had higher cTnI values compared to experiment group （ P 〈 0.05） at 1 hour return to ICU. Ultrastructure changes were slighter in experiment group than in control group. Arrest time of control group was longer than experiment group （ P 〈 0.05 ）. Conclusion Adenosine could decrease the ischemia- reperfusion injury in infant open heart surgery, and has better myocardial protective effect.