【摘要】 目的应用心肌肌钙蛋白评价心脏瓣膜置换术中含血停搏液对心肌保护的优越性。方法将５０例心脏瓣膜置换术患者随机分为冷血心脏停搏液（ＢＣＰ）组和晶体心脏停搏液（ＣＣＰ）组，分别于转流前、主动脉阻断３０分钟和６０分钟、开放主动脉后２０分钟、术后１天、３天和７天采血测定心肌肌钙蛋白Ｔ亚单位（ｃＴｎＴ）及心肌酶谱。结果ｃＴｎＴ的敏感性优于心肌酶谱，ｃＴｎＴ的释放和心肌酶的渗出与心肌缺血时间成正比，主动脉阻断３０分钟以上者差异有显著性（Ｐ＜０．０１和Ｐ＜０．０５），心脏自动复跳率和术后正性肌力药物的应用ＢＣＰ组均优于ＣＣＰ组（Ｐ＜０．０５）。结论ｃＴｎＴ可作为心脏外科心肌保护措施的常规检测指标，冷血心脏停搏液对长时间缺血心肌的保护作用优于晶体心脏停搏液更多还原

【Abstract】 Objective To evaluate the advantages of blood cardioplegia in heart valve replacement by detection of the cTroponin. Methods Fifty patients for heart valve replacement were randomly divided into two groups:cold blood cardioplegia solution group(BCP group) and crystalloid cardioplegia solution group(CCP group).cTroponin T (cTnT) and myocardium enzymes were measured in each group respectively before bypass, 30 and 60 minutes after the aorta clamping, 20 minutes after the aorta off clamping, 1 day,3 days and 7 days after the operation. Results cTnT is more sensitive than myocardium enzymes. The release of cTnT and the exadation of myocardium enzymes are both proportional to the ischemic time of myocardium. There is significantly difference in case of being clamped more than 30 minutes ( P <0 01, P <0 05).BCP group is better than CCP group at aspects of automatic rebeating rate and the application of positive inotropics ( P <0 05). Conclusion cTnT can be used routinely to evaluate the myocardium preservation in cardiac surgery. Cold blood cardioplegia solution is superior to crystalloid one for the long time ischemia of myocardium.更多还原