目的 观察腺苷在复杂先心病直视手术中的心肌保护效果.方法 40例复杂先心病直视手术患者随机分为两组,每组20例,分别为对照组(含血心脏停搏液)、实验组(含血心脏停搏液中加入外源性腺苷).测定围术期血浆肌钙蛋白Ⅰ(cTn Ⅰ)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)水平.临床观察心脏停跳时间、自动复跳率、术后正性肌力药物的用量、术后机械通气时间、ICU滞留时间.结果 对照组心脏停搏时间明显长于实验组.主动脉开放后对照组CK-MB及cTn Ⅰ高于实验组(P＜0.05).结论 腺苷可减轻心肌缺血再灌注损伤,能显著提高心肌保护效果.%Objective To observe protective effects of adenosine on myocardium during open heart surgery for complicated congenital heart disease. Methods 40 patients scheduled for open heart surgery were randomly divided into two groups ( n = 20 ). In experimental group, exogenous adenosine was added into cardioplegic solution during cardiopulmonary bypass,but in control group, only cardioplegic solution was used. The levels of cardiac treponin - I ( cTn - I ) ,creatine kinase - MB( CK - MB ).lactate dehydrogenase ( LDH ) were measured during perioperative period. Cardiac arrest time . automatic rebeating rate , postoperative consumption of notropic agent, postoperative mechanic ventilation time and duration time in ICU were observed or recorded. Results Cardiac arrest time was significantly longer in control group than that in experimental group. Moreover.the levels of cTn - I and CK - MB were significantly higher in control group than those in experimental group( P ＜ 0. 05 ). Conclusion Adenosine can relieve mvocardial ischemic reperfusion injury and markedly enhance myocardial protective effects.
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