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为什么新生儿的心脏容易受到全球性缺血的影响? 乳酸盐假设是什么
1Division of Cardiovascular and Thoracic Surgery, Montreal General Hospital, Quebec, Canada.
Circulation
|November 1, 1987
概括
新生儿的心脏在缺血期间比成人心脏积累更多的乳酸,导致早期的酸性损伤和损伤. 这表明改善洗对于新生儿心脏保存至关重要.
科学领域:
- 心脏病学 心脏病学
- 新生儿生理学 新生儿生理学
- 生物化学 生物化学
背景情况:
- 与成人心脏相比,新生儿心脏对缺血性损伤的脆弱性受到争论.
- 狗类研究表明,全球性缺血后新生儿心脏的收缩速度更快.
- 新生儿的心脏表现出更好的耐受性低氧 perfusion 尽管更快的收缩.
研究的目的:
- 调查假设,在不成熟的心肌中,更大的无氧糖解会导致乳酸积累的增加.
- 为了确定这种乳酸积累是否会导致组织酸化和新生儿心脏早期不可逆转的损伤.
- 为了协调新生儿心脏对缺氧的耐受性与观察到更快的缺血收缩症的发现.
主要方法:
- 切除的新生儿和成年老鼠心脏在常温条件下化,持续时间不同 (0-15分钟).
- 心肌乳酸含量在两个年龄组都被测量.
- 一组小鼠在心脏切除前接受了KCl诱导的心脏,以评估停止条件下的乳酸水平.
主要成果:
- 新生儿心肌乳酸含量明显高于成人心脏 (p < .05).
- 新生儿和成人心脏之间的乳酸水平的差异在KCl诱导的心脏之后更加明显.
- 数据支持乳酸积累假说作为早期损伤的原因.
结论:
- 研究结果支持这样一个假设:无氧糖分分解能力增加导致乳酸在缺血期间在新生儿心脏中积累更多的乳酸.
- 乳酸酸的升高会导致组织酸和可能更早的不可逆转的心肌损伤.
- 临床新生儿心脏保护策略可能受益于确保适当的洗程序.
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