摘要
目的探讨运用ATP敏感性K+通道开放剂二氮嗪模拟缺血预处理(IP效应)在小儿室缺(先天性心脏病室间隔缺损)手术中的心肌保护作用。方法择期行先天性心脏病室间隔缺损修复术38例,随机分成实验组和对照组。实验组于转流前通过颈内静脉插管直接将二氮嗪(2 mg/kg)静注到靠近右心房的上腔静脉。对照组静脉滴注等量的生理盐水。对比各时间点心肌肌钙蛋白T(cTnT)、磷酸肌酸激酶同工酶(CK-MB)含量,及心肌超微结构变化。结果实验组血清酶学方面cTnT在阻断30 m in后,CK-MB在手术结束后均优于对照组(P<0.05),实验组线粒体评分与对照组相比较差异有显著性意义(P<0.05),提示实验组心肌损伤较对照组轻。结论ATP敏感性K+通道开放剂二氮嗪模拟了IP效应,减轻人类心肌在室缺(先天性心脏病室间隔缺损)手术心肌长时程(主动脉阻断时间>20 m in)缺血再灌注损伤。
Objective To investigate the myocardioprotective effects of ATP-sensitive potassium channel open medicine preconditioning in patients with ventricular septal defect. Methods Thirty eight patients with ventricular septal defect were randomly divided into treated and control group. ATP-sensitive potassium channel open medicine（Diazozide） was elicited in the treated group before the cardiopulmonary by-pass. The levels in serum cTnT, CK-MB were measured. The injury score of the mitochondria was assessed under electromicroscopy. Results At 30 min after closing the aorta, the cTnT in the treated group was significantly lower than that in the control group（P〈0. 05）. At the end of surgical operation, the CK-MB in the treated group was significantly lower than that in the control group（P〈0. 05）. The mitochondria injury score in the treated group was much lower than that in the control group at 30 min after opening the aorta （P〈0. 05）. Conclusions ATP-sensitive potassium channel open medicine preconditioning can reduce ischemic-reperfusion injury during the operation in patients with ventricular septal defect.
出处
《中华小儿外科杂志》
CSCD
北大核心
2006年第8期397-399,共3页
Chinese Journal of Pediatric Surgery
关键词
缺血预处理
心肌
室间隔缺损
Ischemic preconditioning,myocardial
Heart septal defects, ventricular
