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目的:研究低温、多剂和单剂晶体停搏液对未成熟心肌能量代谢和超微结构的保护.方法:建立未成熟幼兔离体工作心模型,利用高效液相色谱法(HPLC)和分光光度法检测未成熟心肌缺血前后心肌高能磷酸化合物(ATP、ADP、AMP 和 CP)和糖原含量,并观察心肌超微结构的改变。结果:缺血再灌注后,Ⅱ组(多剂晶体停搏液组)ATP、CP 和糖原保存最差,分别是4.0±0.4,5.8±0.4μmol/g 干重和639±40/μg/g 干重,Ⅰ组(低温组)和Ⅲ组(单剂灌注组)则相应分别是6.1±0.3,8.8±0.5μmol/g 干重,732±37μg/g 干重(P 均<0.01)和6.0±0.4,9.0±0.5μmol/g 干重,776±50(μg/g 干重(P 均<0.01);心肌超微结构观察显示,Ⅲ组保存优于Ⅰ组和Ⅱ组。结论:单剂晶体停搏液对未成熟心肌能量代谢和超微结构保护最佳。
OBJECTIVE: To study the protection of hypothermia, multi-dose and single-dose crystalloid cardioplegia on the energy metabolism and ultrastructure of immature myocardium.Methods: The working heart model of immature rabbit was established, and the effects of high-performance liquid chromatography The contents of ATP, ADP, AMP, CP and glycogen in myocardial cells before and after immature myocardial ischemia were measured by spectrophotometry. The ultrastructural changes in myocardium were observed. Results: After ischemia / reperfusion, the ATP, CP and glycogen of Group Ⅱ (multi-dose crystalloid cardioplegia group) were the best preserved at 4.0 ± 0.4,5.8 ± 0.4μmol / g dry weight and 639 ± 40 / μg / g dry weight, dry weight of 732 ± 37μg / g (P <0.01) and dry weight of group Ⅰ (low temperature group) and group Ⅲ (single dose group) were 6.1 ± 0.3,8.8 ± 0.5μmol / 6.0 ± 0.4,9.0 ± 0.5μmol / g dry weight and 776 ± 50μg / g dry weight (P <0.01). The ultrastructure of myocardium showed that the preservation of group Ⅲ was superior to that of group Ⅰ and Ⅱ.Conclusion: Agent crystalloid cardioplegia on the immature myocardial energy metabolism and ultrastructure protection best.