心脏症的其他替代技术
T M Yau1, R D Weisel, D A Mickle
1Division of Cardiovascular Surgery, Toronto Hospital, Ontario, Canada.
Circulation
|November 1, 1992
概括
在心脏手术期间,不同的心脏技术会影响心肌肉代谢. 温暖的前级心肌最大限度地增加了氧气消耗,而冷心肌保留了腺核酸,但抑制了线粒体功能.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 生物化学 生物化学
背景情况:
- 常温性心肌是临床上被接受的,但其代谢作用尚未完全理解.
- 有限的研究存在于各种心肌保护策略的代谢后果.
研究的目的:
- 为了比较冠状动脉旁路移植手术期间三种心脏技术的代谢效应.
- 为了评估心肌肌肉代谢恢复后不同的心脏的方法.
主要方法:
- 一项随机临床试验,涉及74名接受冠状动脉旁路移植手术的患者.
- 患者接受了正常热前级,正常热后级或间歇性冷血前级心脏.
- 测量包括心肌氧消耗,乳酸盐生产,腺因核酸和心肌激酶单酶 (CK-MB) 释放.
主要成果:
- 温暖的前级心脏最大限度地增加了心肌的氧气消耗.
- 温暖逆行性心肌导致了最高的无氧乳酸生产.
- 寒冷心脏导致腺核酸积累并抑制了线粒体功能,而温暖的前级心脏导致了腺三酸盐 (ATP) 前体的洗.
结论:
- 间歇性冷心保留了腺核酸,但影响了线粒体功能.
- 温暖的前级心脏显示了心肌肌肉氧气消耗的增加.
- 两组之间没有观察到临床结果或术后CK-MB释放的显著差异.
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