Obadia J F, Ben Baouali A, Maupoil V, Rochette L
"Louis Pradel" Cardiologic Hospital, Lyon, France.
J Cardiovasc Surg (Torino). 1996 Feb;37(1):45-51.
Post-ischemic reperfusion phenomenon has been studied in two methods of myocardial protection: a crystalloid cardioplegia (St Thomas no.2) and a cold blood cardioplegia (Buckberg) during cardiopulmonary bypass for myocardial revascularisation in patients. Myocardial protection has been assessed from the evolution of hemodynamic parameters, reperfusion arrhythmias and biochemical analysis of the coronary flow after cross-clamp removal: creatinine phosphokinase (CPK_MB) and nucleotide adenine metabolites (adenosine, inosine, hypoxanthine, xanthine and uric acid). The study was performed in two groups of 14 patients. Hemodynamic conditions were similar in both groups during reperfusion in order to avoid different coronary flow. In those conditions, myocardial protection by cold blood cardioplegia reduced reperfusion arrhythmias, and resulted in a loss of CPK-MB release. Furthermore, the reduction of metabolites release, purine bases and oxypurine bases into coronary sinus after cold blood cardioplegia suggest a better protection of myocardial high energy phosphates in this group than after crystalloid cardioplegia. Our results also show that hypoxanthine is probably the final product of ATP degradation in human myocardial tissue.
在接受心肌血运重建的患者体外循环期间，一种是晶体停搏液（St Thomas no.2），另一种是冷血停搏液（Buckberg）。通过血流动力学参数的变化、再灌注心律失常以及松开主动脉阻断钳后冠状动脉血流的生化分析（肌酸磷酸激酶（CPK_MB）和核苷酸腺嘌呤代谢产物（腺苷、肌苷、次黄嘌呤、黄嘌呤和尿酸））来评估心肌保护情况。该研究在两组各14例患者中进行。为避免冠状动脉血流不同，两组在再灌注期间的血流动力学状况相似。在这些条件下，冷血停搏液的心肌保护作用减少了再灌注心律失常，并导致CPK-MB释放减少。此外，冷血停搏液后冠状动脉窦中代谢产物、嘌呤碱和氧嘌呤碱的释放减少，表明该组对心肌高能磷酸盐的保护优于晶体停搏液后。我们的结果还表明，次黄嘌呤可能是人类心肌组织中ATP降解的最终产物。
