摘要
目的 测量未成熟心肌缺血前后能量物质 CP,ATP,ADP及 AMP的变化 .方法 小于 2岁先天性心脏病( CHD)患儿 18例 ,分别于心肌缺血前后取右心耳心肌组织HPL C测定心肌能量物质 CP,ATP,ADP及 AMP.结果 体外循环前 ,后右心房心肌中能量物质比较发现 ,ATP,ADP在缺血后分别下降到缺血前的 32 %和 6 4% ,而 CP,AMP值却保持较高水平 ;按年龄 1岁 ,分成 2组 ( 组 >1岁 ; 组 <1岁 ) .比较两组术后高能磷酸化合物水平 ,发现 组 AMP水平大于 组 ( P<0 .0 5 ) ,但两组间 ADP,CP,非扩散核苷酸 ( TNN)水平差异不显著 ; 组 ATP比 组 ATP恢复率低 ( P<0 .0 5 ) ,而 AMP恢复率大于 组 ,但两组间 ADP,CP,TNN恢复率差异不显著 .结论 较低 5′- NT活性可能有利于未成熟心肌中 TNN的保存 ,但未成熟心肌目前条件下能量物质丢失较为严重 ,尤其 ATP的水平较低 .磷酸肌酸在开放后恢复迅速 ,可能在复灌初腺嘌呤核苷酸水平低下下发挥了过渡作用 ,其机制尚待进一步研究证实 .未成熟心肌在不同生长发育阶段 ,缺血后高能磷酸能量物质代谢可能有差异 . 组优于
AIM To determinate the levels of ATP, ADP,AMP, CP with highperformance liquid chromatography in immature hearts which underwent cardiopulmonary bypass. METHODS Eighteen infants (10 boys and 8 girls) with congenital heart disease were examined. The mean age of (11.2±7.8) months was within the range of 19 days to 24 months,and 8 patients were less than 12 months. The mean body weight was (10.2±3.13) kg with a range of 3.0 to 13.8 kg. The highenergy phosphate bond of right cardiac atrium was measured in prebypass and postbypass. RESULTS After reperfution, ATP, ADP were redused to 34.6%, 63.6% of baseline, while CP kept a high level. Then the patients were divided into two groups by age: Group I (less than 12 months, n=8); Group II (more than 12 months, n=10). The rate of recovery of ATP (31.7%) in group I was lower than in groupII (48.2%, P<0.05), while AMP (104.1%) was higher than group II (63.1%, P<0.01). No difference was observed in ADP, CP, the total nondiffusible nucleotides (TNN* except IMP) between two groups. CONCLUSION In spite of lower activity 5′NT, highenergy phosphate depletion in the immature heart was higher than expected. The quick retrieve of CP may be intergradient. The immature heart may have an agerelated differences level of ATP, AMP postischemia. In this study, group II had a better result than group I.
出处
《第四军医大学学报》
2000年第5期568-570,共3页
Journal of the Fourth Military Medical University
基金
国家自然科学基金资助项目!(39500144)
关键词
先天性心脏病
心肌缺血
心脏外科手术
CP
ATP
high-performance liquid chromatography
immature heart
adenosine triphosphate
adenosine diphosphate
phosphocreatine
