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目的 :对比研究含氧血心脏停搏液连续灌注与冷晶体心脏停搏液间断灌注后心肌线粒体量化计分及超微结构的变化。方法 :患者分为三组 (每组 8例 )。主动脉阻塞前及再灌注后 2 0～ 30分钟各取 1m m3心室壁肌肉置入 4℃ 2 %戊二醛液中固定。在电镜下选择 5个视野 ,每个视野随机观察 2 0个线粒体。依受损程度分为 0～ 4级 ,将 10 0个线粒体按级得分总和除以 10 0即为该组得分数。结果 :再灌注 2 0～ 30分钟后冷晶组计分为 (2 .6 92± 0 .46 2 ) (P<0 .0 5 ) ;浅低温血组计分为 (1.0 6 7±0 .377) ;常温血组计分为 (1.16 5± 0 .30 2 )。结论 :电镜下线粒体超微结构及量化计分证明了含氧血组心肌保护明显优于冷晶组。
OBJECTIVE: To compare the changes of myocardial mitochondrial quantification score and ultrastructure after continuous perfusion of cardioplegia with oxygenated blood and intermittent perfusion of cold crystalloid cardioplegia. Methods: The patients were divided into three groups (8 in each group). Aortic occlusion before and after reperfusion 2 0 ~ 30 minutes each take 1m m3 ventricular muscle placed 4 ℃ 2% glutaraldehyde solution. Five fields were selected under electron microscope and 20 mitochondria were randomly observed in each field. According to the degree of damage is divided into 0 to 4, the 10 0 mitochondrial total score divided by 10 0 is the score of the group. Results: The score of cold crystal group was (2.62 ± 0.46 2) (P <0.05) after reperfusion from 0 to 30 minutes, and the score of mild hypothermia group was (1.0 6 7 ± 0) 377); normal blood group score (1.16 5 ± 0.30 2). Conclusion: The ultrastructure of mitochondria and quantitative scoring under electron microscopy demonstrate that myocardial protection in oxygenated blood group is better than that of cold crystal group.