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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 组
Objective To measure the changes of CP, ATP, ADP and AMP of energy substances before and after immature myocardial ischemia.Methods 18 children with congenital heart disease (CHD) less than 2 years old were measured myocardial HPL C before and after myocardial ischemia Myocardial energy substances CP, ATP, ADP and AMP.Results Compared with before and after cardiopulmonary bypass, ATP, ADP decreased to 32% and 64% respectively after ischemia, but CP, (P <0. 0), while the AMP value remained at a high level.At the age of 1 year, the patients were divided into 2 groups (group> 1 year old and group <1 year old) .The levels of AMPs in the two groups were compared, 5), but there was no significant difference in the levels of ADP, CP and non-proliferation nucleotides (TNN) between the two groups; the recovery rate of ATP in group ATP was lower than that in group (P <0.05) There was no significant difference in recovery rate of ADP, CP and TNN among the groups.Conclusion Lower 5’- NT activity may be beneficial to the preservation of TNN in immature myocardium, but the immature myocardium is more likely to lose energy substance under current conditions, especially ATP level Low. Creatine phosphate restored rapidly after opening, probably during early reperfusion adenine nucleotide water Under the condition of low level and low level, it played a transitional role, and its mechanism remains to be confirmed by further studies. The immature myocardial cells may have different energy metabolism after high blood pressure at different growth and development stages.