CAJ | 학술논문

目的　为寻找更有效的心肌保护方法，观察腺苷预处理时人心肌细胞能量代谢和超微结构的变化。方法　将主动脉阻断时间在60 min以上的心脏直视手术病人16例，随机均分为腺苷预处理组和对照组。分别于麻醉后、主动脉阻断后60 min及主动脉开放后30 min取部分心肌组织测定三磷酸腺苷（ATP）及能量储备（EC），并观察超微结构变化。结果　腺苷预处理组心肌细胞ATP含量及EC值明显高于对照组（P＜0.05）；电镜见心肌损伤亦明显减轻。结论　腺苷能模拟缺血预处理效应，明显减轻缺血心肌的能量消耗，保护线粒体的结构和功能，从而证实其对缺血心肌具有保护作用。
목적　위심조경유효적심기보호방법，관찰선감예처리시인심기세포능량대사화초미결구적변화。방법　장주동맥조단시간재60 min이상적심장직시수술병인16례，수궤균분위선감예처리조화대조조。분별우마취후、주동맥조단후60 min급주동맥개방후30 min취부분심기조직측정삼린산선감（ATP）급능량저비（EC），병관찰초미결구변화。결과　선감예처리조심기세포ATP함량급EC치명현고우대조조（P＜0.05）；전경견심기손상역명현감경。결론　선감능모의결혈예처리효응，명현감경결혈심기적능량소모，보호선립체적결구화공능，종이증실기대결혈심기구유보호작용。
Objective　To investigate the effect of adenosine preconditioning on changes of energy metabolism and ultrastructure of myocardium. Methods　Sixteen patients who underwent open heart surgery were randomly divided into adenosine group and control group with 8 cases in each group. Myocardial tissue was taken at three different time intervals: before cardiopulmonary bypass, 60 minutes after clamping the aorta and 30 minutes after declamping the aorta. The levels of ATP, and EC value were measured. The changes of myocardial ultrastructure were studied. Results　The myocardial levels of ATP and EC in adnosine group were much higher than those in control group (P＜0.05). In adenosine group, electron microscopic findings of myocardial damage were less severe than those in control group. Conclusion　Through mimicing preconditioning, adenosine can reduce the depletion of ATP, protect the structure and function of mitochondria. This may be one of the mechanisms of adenosine preconditioning.