【摘要】 目的探讨腺苷预处理对人未成熟心肌缺血再灌注损伤的保护作用及其可能机制。方法将42例5岁以下行室间隔缺损修补术的患儿随机分成腺苷组和对照组,每组21例。腺苷组在术前用腺苷预处理,对照组经相同路径滴入相同体积的生理盐水后开始转流。观察心肌肌钙蛋白-I(cTnI)、肌酸激酶同工酶(CK-MB)、心肌超微结构改变,记录和计算两组自动复跳率、T波倒置发生率、室性心律失常发生率、术后平均住院日(d)。结果腺苷预处理明显减少了cTnI、CK-MB的漏出,在心肌超微结构和心电活动方面具有良好的保护作用。结论腺苷预处理对人未成熟心肌缺血再灌注损伤具有保护作用。更多还原

【Abstract】 Objective To explore the protective effect of adenosine preconditioning on immature human myocardium under ischemia-reperfusion injury.Methods Forty-two patients (less then 5 years old) undergoing remedy operation for VSD under cardiopulmonary bypass were preoperatively randomized into an adenosine group (n=21) and a control group (n=21).In group A,adenosine was infused into superior vena cava via internal jugular vein cannula at a speed of 30～50?μg/(kg·min) which would be regulated according to blood pressure before CPB.In group B,the same amount of NS was infused instead of adenosine.The blood cTnI,CK-MB and ultrastructure examination under an electron microscope were studied.The rate of automatic resume pulsating,incidence of inverted T wave,incidence of ventricular arrhythmia and mean hospital stay (day) were analyzed and calculated.Results Adenosine preconditioning obviously decrease the leakage of cTnI and CK-MB and had a protective effect on the myocardial ultrastructure and electrocardial activity.Conclusion Adenosine preconditioning can protect immature human myocardium from ischemia-reperfusion injury.更多还原