【摘要】：目的：對(duì)比研究冷自體血心臟停搏液與HTK液在嬰幼兒體外循環(huán)室間隔缺損修補(bǔ)術(shù)心肌缺血與再灌注早期心肌HSP70、SOD釋放的影響,揭示冷自體血心臟停搏液在體外循環(huán)心臟直視手術(shù)中對(duì)未成熟心肌的內(nèi)源性保護(hù)作用。 方法：年齡≤1歲行體外循環(huán)室間隔缺損修補(bǔ)術(shù)的患兒40例,隨機(jī)分為實(shí)驗(yàn)組與對(duì)照組各20例。主動(dòng)脈阻斷后,分別用冷自體血心臟停搏液、HTK液經(jīng)主動(dòng)脈根部進(jìn)行灌注。于主動(dòng)脈阻斷前即刻、主動(dòng)脈開(kāi)放后第1分鐘及第15分鐘抽取冠狀靜脈竇回流血及體靜脈回流血,應(yīng)用酶聯(lián)免疫吸附法(ELISA法)檢測(cè)HSP70、SOD濃度。運(yùn)用t檢驗(yàn)進(jìn)行統(tǒng)計(jì)學(xué)處理。 結(jié)果：同組主動(dòng)脈開(kāi)放后與主動(dòng)脈阻斷前比較,HSP70、SOD濃度明顯升高(P0.05,P0.01)。兩組比較,主動(dòng)脈阻斷前兩組之間差異無(wú)顯著性(P0.05),主動(dòng)脈開(kāi)放后冷自體血心臟停搏液組HSP70、SOD濃度明顯高于晶體心臟停搏液組(P0.05)。 結(jié)論：嬰幼兒體外循環(huán)室間隔缺損修補(bǔ)術(shù)心肌缺血與再灌注早期心肌HSP70、SOD釋放增加。冷自體血心臟停搏液在嬰幼兒體外循環(huán)心肌缺血與再灌注早期的過(guò)程中可促進(jìn)HSP70、SOD釋放,對(duì)嬰幼兒心肌有內(nèi)源性保護(hù)作用。
[Abstract]:Objective: to compare the effects of cold autologous blood cardioplegia solution and HTK solution on myocardial HSP70,SOD release during myocardial ischemia and reperfusion in infants with ventricular septal defect repair by cardiopulmonary bypass (CPB). This study revealed the endogenous protective effect of cold autologous cardioplegic solution on immature myocardium during open heart surgery with cardiopulmonary bypass (CPB). Methods: forty children with ventricular septal defect repair by cardiopulmonary bypass were randomly divided into two groups: experimental group (n = 20) and control group (n = 20). After aortic cross-clamping, cold autologous blood cardioplegic solution and HTK solution were perfused through aortic root respectively. HSP70,SOD concentration was measured by enzyme-linked immunosorbent assay (ELISA) immediately before aortic cross-clamping and 1 and 15 minutes after aortic opening. The coronary sinus and systemic venous circulation were extracted from the coronary sinus and systemic venous circulation immediately before aortic cross-clamping and 1 and 15 minutes after aortic opening. T-test was used for statistical analysis. Results: the concentration of HSP70,SOD in the same group was significantly higher than that before aortic cross-clamping (P 0.05, P0.01). There was no significant difference between the two groups before aortic occlusion (P0.05). The concentration of HSP70,SOD in cold autogenous blood cardioplegia group after aortic opening was significantly higher than that in lens cardioplegia group (P0.05). Conclusion: myocardial HSP70,SOD release increased in the early stage of myocardial ischemia and reperfusion in infants with ventricular septal defect repair by cardiopulmonary bypass. Cold autogenous cardioplegia can promote the release of HSP70,SOD during the early stage of myocardial ischemia and reperfusion in infants with cardiopulmonary bypass, and has endogenous protective effect on infant myocardium.
【學(xué)位授予單位】：遵義醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類(lèi)號(hào)】：R726.5

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