温氧合血心停搏液微流量连灌与微温氧合血间灌心肌线粒体量化计分的对比研究

目的观察温氧合血（35℃）心停搏液微流量连灌与微温氧合血（26—28℃）间灌心肌线粒体量化计分及超微结构的变化。方法选择20例择期心脏瓣膜置换术，按机械分类法随机分为两组（每组10例）。A组采用常CPB温氧合血（35℃）心停搏液微流量连灌；B组采用浅低温CPB微温氧合血（26～28℃）心停搏液间灌。分别于主动脉阻断时和再灌注30分钟各取左室壁心肌（1～2mm3），电镜观察并摄片。在电镜下选择5个视野，每个视野随机观察20个线粒体，依受损程度分为0～4级，将100个线粒体按级得分总和除以100即为该组得分数。结果两组在主动脉阻断时心肌超微结构基本正常，再灌注30分钟，A组得分（1．2346±0．2621），B组得分（1．1632±0．2153），两组间比较无显著性差异（P〉0．05）。结论在瓣膜置换术中两组含血心停搏液的心肌保护作用近似，微温血心停搏液具有更好的心肌保护作用。

Comparative study of mitochondria scoring and ultrastructural changes of myocardium on warm oxygenated blood continuous perfusion and tepid oxygenated cold intermittent perfusion

Objective The study carried out to study the cardiac protection effect with the mitochondria sooting and ultrastructural changes between continuous warm oxygenated blood cardioplegia （ 35 ℃ ）minimum-flow penfusion and intemittent antegrade tepid oxy- genated blood cardioplegia （26-28 ℃ ） perfusion. Methods 20 patients undergoing valve replacement was divided into two groups （ 10 patients each groups;） （1） continuous warm oxygenated blood cardioplegia（n=10） and （2） intermittent antegrade tepid oxygenated blood cardioplegia （n=10）. Ahead aorta was clamped and 30 minutes after reperfusion, a piece of myocardium was obtained, and fixed in 2.5% distilled glutardehvde for 2 hours, at 4℃.They were observed under eletron microscope According to Flameng method, every mitoehondria was graded on score 0-4 scale sem iguantatively. A verage score of 100 mitochondria per sample was calculated. Results： uhrastructure of the myecardium were not significanly different between two groups before the aortic cross-clamping, mitoehondria score of A group, （1.2346 ± 0.2621）,and B gorup,（1.632 ± 0.2153） P 〉 0.05 at 30 minutes after reperfusion .Conclusion：During cardiac valve replacement tow groups blood carolioplegia has a similar effect on myocardial protection. Intermittent antegrade tepid blood eardioplegia is superior to contuuous warm blood cardiopleaia of myocardial protection.