Laky D, Candea V, Butub G, Nicolau N, Socolovschi S, Hahalau F L
Victor Babes Institute, Bucharest, Romania.
Rom J Morphol Embryol. 1995 Jan-Jun;41(1-2):63-71.
Morphophysiopathologic modifications occurred in myocardium, liver and lung during open heart operations under extracorporeal circulation had been studied using histologic, histoenzymologic, ultrastructural and biochemical investigations. Preexisting myocardic and hepatic lesions subsequent to chronic stasis and hypoxia are accentuated due to the "controlled shock" state induced by extracorporeal circulation. Mitochondrial marker enzymes like SDH, LDH and ATP-ase in the membrane are decreasing their levels and hydrolytic enzymes like acid phosphatase, nonspecific esterase (ANAE) and peroxidase are increasing their activity. These disseminated lesions can become irreversible under the conditions of a severe cardial insufficiency and of a prolonged operation. In the lung, the increase in the hydrolytic enzyme activity suggests the processes of phagocytosis and metabolization of red cells by macrophages.
利用组织学、组织酶学、超微结构和生物化学研究方法,对体外循环下心内直视手术过程中心肌、肝脏和肺的形态生理病理改变进行了研究。体外循环所致的“控制性休克”状态会加剧慢性淤血和缺氧导致的心肌和肝脏原有病变。线粒体标记酶如琥珀酸脱氢酶(SDH)、乳酸脱氢酶(LDH)和膜上的三磷酸腺苷酶(ATP酶)水平降低,而酸性磷酸酶、非特异性酯酶(ANAE)和过氧化物酶等水解酶活性增加。在严重心功能不全和手术时间延长的情况下,这些弥漫性病变可能会变得不可逆转。在肺中,水解酶活性的增加提示巨噬细胞对红细胞的吞噬和代谢过程。