Sakata J, Morishita K, Ito T, Koshino T, Kazui T, Abe T
Department of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, Hokkaido, Japan.
J Card Surg. 1998 Jan;13(1):43-7. doi: 10.1111/j.1540-8191.1998.tb01053.x.
This study was conducted to compare the effect of histidine-triptophan-ketoglutalate solution (HTK) with that of cold blood cardioplegic solution (CBC) in mitral valve surgery.
Forty-six patients who underwent mitral valve replacement between January 1994 and December 1996 were enrolled in this study. Twenty patients received HTK (HTK group), while 27 patients had CBC (CBC group) as myocardial protection. HTK was given as a single high dose, whereas CBC was used in the usual multidose format.
The doses of inotropic agent at the end of extracorporeal circulation did not differ between the HTK group and the CBC group. Creatine kinase values (units) on day 1 and day 2 were 1140+/-412, 921+/-436 for the HTK group and 904+/-335, 816+/-420 for the CBC group, respectively (p = NS). Spontaneous defibrillation occurred in 26% of the CBC group and 90% of the HTK group (p < 0.05). Pacing was temporarily used in 20% of the HTK group and 44% of the CBC group after extracorporeal circulation (p < 0.05).
These results suggest that HTK provided more adequate myocardial protection in mitral valve surgery.
本研究旨在比较组氨酸-色氨酸-酮戊二酸溶液（HTK）与冷血心脏停搏液（CBC）在二尖瓣手术中的效果。
选取1994年1月至1996年12月期间行二尖瓣置换术的46例患者纳入本研究。20例患者接受HTK（HTK组），27例患者接受CBC（CBC组）作为心肌保护措施。HTK以单次高剂量给药，而CBC采用常规多剂量给药方式。
体外循环结束时，HTK组和CBC组的强心剂用量无差异。HTK组第1天和第2天的肌酸激酶值（单位）分别为1140±412、921±436，CBC组分别为904±335、816±420（p=无显著性差异）。CBC组26%的患者和HTK组90%的患者发生了自发除颤（p<0.05）。体外循环后，HTK组20%的患者和CBC组44%的患者临时使用了起搏（p<0.05）。
这些结果表明，HTK在二尖瓣手术中提供了更充分的心肌保护。
