【摘要】 目的　从代谢角度了解冠状动脉搭桥温血心肌保护的效果。方法　 5 2例冠状动脉搭桥患者于阻断升主动脉前后不同时间点抽取心肌灌注血及灌注后流出血 ,观察心肌代谢指标动态变化及心肌损伤特异性标志物释放量。结果　升主动脉阻断末期顺灌组心肌氧摄取率为 2 6 .7%± 10 .6 % ,逆灌组为 32 .4 %± 12 .4 %。心肌无显著酸性产物或乳酸释放。开放升主动脉后组内及组间比较 ,心肌氧摄取率、酸性产物及乳酸释放量无显著性差异(P >0 .0 5 ) ,无即刻显著肌酸磷酸激酶同工酶 (CK MB)及肌钙蛋白T释放。结论　冠状动脉搭桥术中温血心肌保护维护了心肌有氧代谢的连续性更多还原

【Abstract】 Objective To investigate the clinical effects of warm blood cardioplegia for CABG in metabolic respects.Methods Fifty two patients undergoing elective coronary artery bypass grafting (CABG) were included.Cardiac influent and effluent were drawn out at different time points during and after the aortic cross clamp period in the antegrade perfusion and retrograde group.The dynamic changes of the myocardial metabolism and specific myocardial injury markers were measured.Results At the end of the cross clamp period, oxygen extraction ratio (O 2ER) was 26.7%±10.6% in the antegrade group,and 32.4%±12.4% in the retrograde group.No siginificant acid metabolites and lactate were released in both groups.After decamp,as compared within the group and between groups,O 2ER,acid metabolites and lactate release remained same.There was no instantaneous CK MB and troponin T release in both groups.Conclusions Warm blood cardioplegia for CABG maintained aerobic metabolic process continuously.更多还原