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目的观察腺苷在体外循环手术中的心肌保护效果。方法 18例犬随机分为3组,每组6例,分别为对照组(Ⅰ组)、腺苷停搏液组(Ⅱ组)、预处理组(Ⅲ组)。测定围术期血浆心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CKMB)、白细胞介素-6(IL-6)、白细胞介素-10(IL-10)水平。术中取右心房心肌组织观察心肌缺血前后超微结构改变。观察心脏停跳时间、自动复跳率、术后拔管时间。结果Ⅰ组心脏停搏时间明显长于其他两组。主动脉开放后10m in,cTnI、IL-10Ⅰ组高于Ⅱ组与Ⅲ组(P<0.05),术后1dⅠ组IL-6高于Ⅱ组与Ⅲ组(P<0.05)。超微结构观察Ⅰ组心肌损伤程度较Ⅱ组、Ⅲ组重。结论腺苷可减轻心肌缺血再灌注损伤,具有较好的心肌保护作用。
Objective To observe the myocardial protective effect of adenosine during cardiopulmonary bypass. Methods 18 dogs were randomly divided into 3 groups, 6 in each group, which were control group (group Ⅰ), adenosine cardioplegia group (group Ⅱ) and pretreatment group (group Ⅲ). Perioperative plasma levels of cardiac troponin I, CKMB, IL-6 and IL-10 were measured. Intraoperative right atrial myocardial tissue was taken to observe the ultrastructural changes before and after myocardial ischemia. Observation of cardiac arrest time, automatic rebound rate, postoperative extubation time. Results The cardiac arrest time in group Ⅰ was longer than that in other two groups. The level of IL-6 in 10-month-old cTnI and IL-10Ⅰgroups was significantly higher than those in group Ⅱ and Ⅲ (P <0.05). The degree of myocardial injury in group Ⅰ was heavier than that in group Ⅱ and Ⅲ in ultrastructure observation. Conclusions Adenosine can reduce myocardial ischemia-reperfusion injury, and has good myocardial protective effect.