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HTK液与低温高钾血液停搏液在非紫绀型先天性心脏病矫治中对心肌保护作用的比较分析——一项随机研究

Comparative Analysis of Myocardial Protection with HTK Solution and Hypothermic Hyperkalemic Blood Solution in the Correction of Acyanogenic Congenital Cardiopathies - A Randomized Study.

作者信息

Valente Acrisio Sales, Lustosa Gustavo Porto, Mota Lia Alves Martins, Lima Adriano, Mesquita Fernando Antônio de, Gondim Aloísio, Rodrigues Fábio Alércio, Pompeu Ronald Guedes, Branco Klébia Castelo

机构信息

Hospital de Messejana Dr. Carlos Alberto Studart Gomes Department of Surgery Fortaleza Ceará Brazil Department of Surgery, Hospital de Messejana Dr. Carlos Alberto Studart Gomes, Fortaleza, Ceará, Brazil.

Centro Universitário Unichristus Fortaleza Ceará Brazil Centro Universitário Unichristus, Fortaleza, Ceará, Brazil.

出版信息

Braz J Cardiovasc Surg. 2019 Jun 1;34(3):271-278. doi: 10.21470/1678-9741-2018-0243.

DOI:10.21470/1678-9741-2018-0243
PMID:31310464
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6629237/
Abstract

OBJECTIVE

The goal of the present study was to compare the myocardial protection obtained with histidine-tryptophan-ketoglutarate (HTK) cardioplegic solution (Custodiol®) and with intermittent hypothermic blood solution.

METHODS

Two homogenous groups of 25 children with acyanotic congenital heart disease who underwent total correction with mean aortic clamping time of 60 minutes were evaluated in this randomized study. Troponin and creatine kinase-MB curves, vasoactive-inotropic score, and left ventricular function were obtained by echocardiogram in each group. The values were correlated and presented through graphs and tables after adequate statistical treatment.

RESULTS

It was observed that values of all the studied variables varied over time, but there was no difference between the groups.

CONCLUSION

We conclude that in patients with acyanotic congenital cardiopathies submitted to total surgical correction, mean aortic clamping time around one hour, and cardiopulmonary bypass with moderate hypothermia, the HTK crystalloid cardioplegic solution offers the same myocardial protection as the cold-blood hyperkalemic cardioplegic solution analyzed, according to the variables considered in our study model.

摘要

目的

本研究的目的是比较组氨酸 - 色氨酸 - 酮戊二酸（HTK）心脏停搏液（Custodiol®）和间歇性低温血液停搏液所提供的心肌保护作用。

方法

在这项随机研究中，评估了两组各25名患有非紫绀型先天性心脏病且接受了平均主动脉阻断时间为60分钟的完全矫正手术的儿童。通过超声心动图获取每组的肌钙蛋白和肌酸激酶 - MB曲线、血管活性 - 正性肌力评分以及左心室功能。在进行适当的统计处理后，将这些值进行关联并通过图表呈现。

结果

观察到所有研究变量的值随时间变化，但两组之间没有差异。

结论

我们得出结论，在接受完全手术矫正、平均主动脉阻断时间约一小时且进行中度低温体外循环的非紫绀型先天性心脏病患者中，根据我们研究模型中考虑的变量，HTK晶体心脏停搏液提供的心肌保护作用与所分析的冷血高钾心脏停搏液相同。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/51335a0efe1f/rbccv-34-03-0271-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/0235d2b71c17/rbccv-34-03-0271-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/d96e8d57abb7/rbccv-34-03-0271-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/0eeeaacdfb0e/rbccv-34-03-0271-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/51335a0efe1f/rbccv-34-03-0271-g03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/0235d2b71c17/rbccv-34-03-0271-g01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/d96e8d57abb7/rbccv-34-03-0271-g04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/0eeeaacdfb0e/rbccv-34-03-0271-g02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ff/6629237/51335a0efe1f/rbccv-34-03-0271-g03.jpg

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Custodiol Solution and Cold Blood Cardioplegia in Arterial Switch Operation: Retrospective Analysis in a Single Center.动脉调转手术中Custodiol溶液与冷血心脏停搏液的应用：单中心回顾性分析
Thorac Cardiovasc Surg. 2016 Jan;64(1):53-8. doi: 10.1055/s-0035-1566235. Epub 2015 Nov 24.
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Comparison of fractal dimension and Shannon entropy in myocytes from rats treated with histidine-tryptophan-glutamate and histidine-tryptophan cetoglutarate.组氨酸-色氨酸-谷氨酸和组氨酸-色氨酸-酮戊二酸处理的大鼠心肌细胞中分数维与香农熵的比较
Rev Bras Cir Cardiovasc. 2014 Apr-Jun;29(2):156-62. doi: 10.5935/1678-9741.20140052.
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