Rinne T, Pehkonen E, Kaukinen S, Tarkka M
Department of Anesthesiology, Tampere University Hospital, Finland.
J Cardiothorac Vasc Anesth. 1993 Dec;7(6):679-83. doi: 10.1016/1053-0770(93)90052-m.
One hundred patients scheduled for elective coronary artery bypass grafting (CABG) were randomly allocated to two groups for myocardial preservation:blood cardioplegia (BCP) or crystalloid cardioplegia (CCP). The study protocol comprised recording of the following parameters: mode of resumption of cardiac rhythm, CK-MB analysis, ECG recording, cardiac output measurement, cross-clamping and perfusion times, and clinical outcome. The study period covered the time from commencement of anesthesia to the first postoperative morning. Spontaneous resumption of sinus rhythm was recorded only in the BCP group (22/51 v 0/49, P < 0.001). CK-MB values were similar in both groups, but 1 hour postoperatively the BCP group had lower values (58.8 +/- 26.7 v 74.5 +/- 31.5 U/L, P = 0.0098 by t test). Fifteen patients in the BCP group did not receive any electric countershock; this subgroup had very low CK-MB values. There were four intraoperative myocardial infarctions in the BCP group and two in the CCP group (BCP: 3/51 v CCP: 3/49, P = 0.68). The results suggest better cardioprotection with blood cardioplegia in this subgroup of patients. Spontaneous resumption of normal cardiac rhythm seems to indicate good myocardial preservation, as reflected in markedly lower CK-MB values in this subgroup.
100例计划接受择期冠状动脉旁路移植术（CABG）的患者被随机分为两组进行心肌保护：血液停搏液（BCP）组或晶体停搏液（CCP）组。研究方案包括记录以下参数：心律恢复模式、肌酸激酶同工酶（CK-MB）分析、心电图记录、心输出量测量、阻断和灌注时间以及临床结局。研究期间涵盖从麻醉开始至术后第一个早晨的时间段。仅在BCP组记录到窦性心律的自发恢复（22/51比0/49，P<0.001）。两组的CK-MB值相似，但术后1小时BCP组的值较低（58.8±26.7比74.5±31.5 U/L，经t检验P=0.0098）。BCP组有15例患者未接受任何电除颤；该亚组的CK-MB值非常低。BCP组有4例术中发生心肌梗死，CCP组有2例（BCP：3/51比CCP：3/49，P=0.68）。结果表明，在该亚组患者中血液停搏液具有更好的心肌保护作用。正常心律的自发恢复似乎表明心肌保存良好，这在该亚组中显著较低的CK-MB值中得到体现。
