【摘要】：目的：對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)中對未成熟心肌的內(nèi)源性保護作用。 方法：年齡≤1歲行體外循環(huán)室間隔缺損修補術(shù)的患兒40例,隨機分為實驗組與對照組各20例。主動脈阻斷后,分別用冷自體血心臟停搏液、HTK液經(jīng)主動脈根部進行灌注。于主動脈阻斷前即刻、主動脈開放后第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HSP70、SOD濃度。運用t檢驗進行統(tǒng)計學處理。 結(jié)果：同組主動脈開放后與主動脈阻斷前比較,HSP70、SOD濃度明顯升高(P0.05,P0.01)。兩組比較,主動脈阻斷前兩組之間差異無顯著性(P0.05),主動脈開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程中可促進HSP70、SOD釋放,對嬰幼兒心肌有內(nèi)源性保護作用。
[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.
【學位授予單位】：遵義醫(yī)學院
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R726.5

【參考文獻】

相關(guān)期刊論文 前10條

1 鄭波;張奇惠;李躍榮;;心肌缺血再灌注損傷機制研究進展[J];濱州醫(yī)學院學報;2008年02期

2 張偉,王明榮,楊宗誠;熱休克反應(yīng)對大鼠缺血再灌注心肌抗氧化酶的保護作用研究[J];重慶醫(yī)學;2002年05期

3 張青;孟保英;彭樂;王濤;馬超;陶靜;;自體冷血停跳液對嬰幼兒心肌保護機制的研究[J];中國當代兒科雜志;2009年08期

4 王波;廖斌;;體外循環(huán)心肌保護方法的研究進展[J];西南軍醫(yī);2008年06期

5 萬里飛,蘇肇伉,祝忠群,陳惠文,陳恩,曹鼎方,胡惠民;冷攣縮對未成熟心肌功能、能量代謝與超微結(jié)構(gòu)的影響[J];臨床心血管病雜志;1999年02期

6 張青;孟保英;彭樂;王濤;馬超;陶靜;;自體冷血停跳液對未成熟心肌保護機制的研究[J];臨床心血管病雜志;2009年04期

7 吳志軍;涂韶松;章響艷;;心肌停搏液的研究近況和應(yīng)用進展[J];浙江臨床醫(yī)學;2008年02期

8 劉軍濤;張宇;;熱休克蛋白70與心肌保護[J];華北煤炭醫(yī)學院學報;2010年03期

9 黃一東,王志剛,林群;晶體和冷血停跳液在心臟直視手術(shù)中的臨床應(yīng)用[J];齊齊哈爾醫(yī)學院學報;2005年05期

10 劉秀華;;缺血后處理內(nèi)源性心臟保護的研究進展[J];生理學報;2007年05期

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