摘要
目的探讨浅低温体外循环心脏跳动中二尖瓣置换术(MVR)对机体免疫功能的影响。方法连续30例风湿性心脏病二尖瓣病变患者随机分为2组行MVR手术,15例在浅低温体外循环心脏不停跳下进行(不停跳组),15例在中低温冷血停搏液灌注心脏停跳下进行(停跳组)。两组均分别于术前,术中、术后不同时点抽取外周血,进行免疫系统功能指标的对比分析。结果不停跳组在术后3 d,C3、C4、IgA已恢复正常,术后7 d,所有指标均恢复正常,而停跳组直到术后7 d,C3、IgG、IgA仍低于术前水平;两组比较可见,术后1 d、3 d不停跳组所有指标差值明显低于停跳组(P<0.05或P<0.01),术后7 d,C3和IgG仍低于停跳组(P<0.05)。结论浅低温体外循环心脏跳动中心内直视手术是一种较接近生理状态的心肌保护方法,对患者术后免疫系统有良好的保护作用,这对患者术后的顺利恢复有积极意义。
OBJECTIVE To evaluate the effects of beating heart mitral valve replacement （MVR） with mild hypothermia extracorporeal circulation（ECC） on immune functions. METHODS 30 patients with rheumatic heart disease were randomly allocated to two groups： beating heart group （15 cases） underwent MVR on beating heart with mild hypothermia ECC and arrested heart group （ 15 cases） underwent MVR on arrested heart with medium hypothermia ECC. The samples of plasma were obtained before operation, during operation and after operation and comparatively analyzed on immune system in two groups. RESULTS In the beating heart group, the levels of complement 3 （ C3 ）, CA and IgA recovered normal in 3 days after operation, and the rest parameters recovered normal in 7 days. But the levels of C3, IgA and IgG in arrested heart ＂group were lower in 7 days after operation than before operation. The levels of all parameters were signifieanflylower in beating heart group than those in arrested heart group in one day after operation （ P 〈 0.05 or P 〈 0.01 ）. In 7 days after operation,the levels of C3 and IgG in beating heart group were lower than those in arrested heart group （ P 〈 0.05）. CONCLUSION The open -heart surgery with beating heart is a good myocardial protective method closed to physiological condition, which has good protective effect on immune function, and can promote the recovery of patients after operation.
出处
《中国体外循环杂志》
2008年第4期207-209,共3页
Chinese Journal of Extracorporeal Circulation
基金
南京市医学重点科技发展项目(ZKX0404)
关键词
心脏跳动
二尖瓣置换术
免疫球蛋白
补体
免疫功能
Beating heart
Mitral valve replacement surgery
Immunoglobulin
Complement
Immune function
