温血再灌注与心肌保护。
Warm reperfusion and myocardial protection.
作者信息
Chocron S, Alwan K, Yan Y, Toubin G, Kaili D, Anguenot T, Latini L, Clement F, Viel J F, Etievent J P
机构信息
Department of Thoracic and Cardiovascular Surgery, Saint-Jacques Hospital, Besancon, France.
出版信息
Ann Thorac Surg. 1998 Dec;66(6):2003-7. doi: 10.1016/s0003-4975(98)00909-6.
BACKGROUND
The aim of this study was to determine whether warm reperfusion improves myocardial protection with cardiac troponin I as the criteria for evaluating the adequacy of myocardial protection.
METHODS
One hundred five patients undergoing first-time elective coronary bypass surgery were randomized to one of three cardioplegic strategies of either (1) cold crystalloid cardioplegia followed by warm reperfusion, (2) cold blood cardioplegia followed by warm reperfusion, or (3) cold blood cardioplegia with no reperfusion.
RESULTS
The total amount of cardiac troponin I released tended to be higher in the cold blood cardioplegia with no reperfusion group (3.9+/-5.7 microg) than in the cold blood cardioplegia followed by warm reperfusion group (2.8+/-2.7 microg) or the cold crystalloid cardioplegia followed by warm reperfusion group (2.8+/-2.2 microg), but not significantly so. Cardiac troponin I concentration did not differ for any sample in any of the three groups.
CONCLUSIONS
Our study showed that the addition of warm reperfusion to cold blood cardioplegia offers no advantage in a low-risk patient group.
背景
本研究旨在以心肌肌钙蛋白I作为评估心肌保护充分性的标准，确定温血再灌注是否能改善心肌保护。
方法
105例行首次择期冠状动脉搭桥手术的患者被随机分为三种心脏停搏策略之一：（1）冷晶体心脏停搏后温血再灌注；（2）冷血心脏停搏后温血再灌注；（3）冷血心脏停搏且无再灌注。
结果
无再灌注的冷血心脏停搏组心肌肌钙蛋白I释放总量（3.9±5.7微克）高于冷血心脏停搏后温血再灌注组（2.8±2.7微克）或冷晶体心脏停搏后温血再灌注组（2.8±2.2微克），但差异无统计学意义。三组中任何一组的任何样本的心肌肌钙蛋白I浓度均无差异。
结论
我们的研究表明，在低风险患者组中，冷血心脏停搏加温血再灌注并无优势。
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