摘要
【目的】评价不停跳体外循环心内直视手术对心肌细胞凋亡的影响和探讨其临床意义。【方法】停跳心内直视手术患者25例(A组),不停跳心内直视手术患者20例(B组),取心肌组织作TUNEL细胞凋亡检测,比较分析术前和术后心肌细胞凋亡率并参照围手术期肌钙蛋白T(cTnT)检测。【结果】两组患者均无低心输出量综合征的发生。心肌细胞凋亡指数A组(0.003±0.002)和B组(0.004±0.003)术前无明显差别(P>0.05);术后心肌细胞凋亡指数A组(0.012±0.008,P<0.001)和B组(0.006±0.004,P<0.001)均高于术前;A、B两组术后心肌细胞凋亡指数差别有明显差别(P<0.05)。围手术期cTnT水平A组在CPB末和术后2 h明显高于B组(P<0.05)。【结论】本实验提示不停跳体外循环心内直视手术引起心肌细胞凋亡和心肌损害小于停跳手术。
[ Objective ] To investigate cardiomyocytes apoptosis in beating heart surgery with extra-corporeal circulation and to evaluate its clinical value. [Methods] Cardiomyocytes apoptosis were detected by TUNEL methods, perioperative cTnT level were record and compared between before and after the open heart surgery in the arrested heart surgery group 25 cases （Group A） and beating heart surgery group 20 cases （Group B）. [Results] There were no low-output syndrome in both two groups. Cardiomyocytes apoptosis index has no difference between Group A （0.003±0.002） and Group B （0.004±0.003） preoperatively （P 〉0.05）, the postoperative apoptosis index were significantly higher than those of preoperative in both Group A （0.012±0.008, P〈 0.001） and Group B （0.006± 0.004,P〈 0.001）. Postoperative apoptosis index in Group A was higher statistically significant （P〈 0.05）. Perioperative cTnT detection revealed a higher level in Group A than in Group B only at the point of CPB end and 2 hours after operation. [Conclusion] These results suggested that beating heart surgery has less implication in cardiomyocytes apoptosis than the conventional arrested heart surgery.
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2007年第5期562-564,569,共4页
Journal of Sun Yat-Sen University:Medical Sciences
基金
广东省自然科学基金(6021339)
