CAJ | 학술논문

目的：探讨含乌司他丁自体冷血心脏停搏液对未成熟心肌细胞凋亡及Bcl-2蛋白、Bax蛋白表达的影响。 　　方法：选取在我院收治的行体外循环室间隔缺损修补术患儿60例，随机分成含乌司他丁冷血停搏液组（实验组， n=30）和自体冷血停搏液组（对照组，n=30）。分别于术前、主动脉开放后10 min分别取手术患儿右心房组织，末端脱氧核苷酸转移酶介导的dUTP缺口末端标记（TUNEL）法观察心肌细胞凋亡情况，免疫组化检测Bcl-2及Bax蛋白表达。 　　结果：主动脉开放10 min两组心肌细胞凋亡指数较体外循环前5 min明显增加（P<0.05），且实验组心肌凋亡指数较对照组明显降低（P<0.05），差异均有统计学意义。主动脉开放10 min两组心肌Bcl-2蛋白与Bax蛋白明显表达，较体外循环前5 min明显增加，且实验组心肌Bcl-2蛋白表达较对照组明显增加，实验组心肌Bax蛋白表达较对照组明显降低，差异均有统计学意义（P<0.05）。 　　结论：含乌司他丁自体冷血停搏液对缺血再灌注心肌有保护作用，值得临床广泛推广。
목적：탐토함오사타정자체랭혈심장정박액대미성숙심기세포조망급Bcl-2단백、Bax단백표체적영향。 　　방법：선취재아원수치적행체외순배실간격결손수보술환인60례，수궤분성함오사타정랭혈정박액조（실험조， n=30）화자체랭혈정박액조（대조조，n=30）。분별우술전、주동맥개방후10 min분별취수술환인우심방조직，말단탈양핵감산전이매개도적dUTP결구말단표기（TUNEL）법관찰심기세포조망정황，면역조화검측Bcl-2급Bax단백표체。 　　결과：주동맥개방10 min량조심기세포조망지수교체외순배전5 min명현증가（P<0.05），차실험조심기조망지수교대조조명현강저（P<0.05），차이균유통계학의의。주동맥개방10 min량조심기Bcl-2단백여Bax단백명현표체，교체외순배전5 min명현증가，차실험조심기Bcl-2단백표체교대조조명현증가，실험조심기Bax단백표체교대조조명현강저，차이균유통계학의의（P<0.05）。 　　결론：함오사타정자체랭혈정박액대결혈재관주심기유보호작용，치득림상엄범추엄。
Objective: To investigate the effect of cold self-blood cardioplegia with ulinastatin on immature myocardial cell apoptosis and protein expressions of Bcl-2, Bax in ventricular septal defect (VSD) infants. Methods: A total of 60 infants received VSD repairing operation with cardiopulmonary bypass (CPB) in our hospital were summarized. The patients were randomly divided into 2 groups:Test group, the infants received cold self-blood cardioplegia with ulinastatin when aortic cross-clamp was closed. Control group, the infants received cold self-blood cardioplegia when aortic cross-clamp was closed. n=30 in each group. The right atrium tissue was collected before CPB and 10 min after releasing aortic cross-clamp. The index of myocardial cell apoptosis was observed by TUNEL method, and the protein expressions of Bcl-2, Bax were examined by immunohistological method. Results: Both groups showed the higher index of myocardial cell apoptosis at 10 min after releasing aortic cross-clamp than 5 min before CPB, and the apoptosis index in Test group was lower than that in Control group, all P<0.05. The protein expressions of Bcl-2 and Bax were obviously increased at 10 min after releasing aortic cross-clamp than 5 min before CPB in both groups. Compared with Control group, Test group presented the higher Bcl-2 protein expression and lower Bax protein expression, all P<0.05. Conclusion: Cold self-blood cardioplegia with ulinastatin could protect immature myocardum from ischemia-reperfusion injury in VSD infants during CPB operation in clinical practice.