ABSTRACT
Objective To study the effect of erythropoietin( EPO) pretreatment on myocardial pro-tection in perioperative period of infant congenital heart disease operation and explore its underlying mecha-nism. Methods All the 80 patients who were suffered from non-cyanotic congenital heart disease undergone cardiopulmonary bypass in open heart operation were selected from Shengjing Hospital of China Medical Uni-versity cardiac surgery ward from April 2014 to January 2017. The patients were randomly divided into A,B, C three groups according to blocked randomization method. Group A patients were treated with subcutaneous injection of EPO 150 IU/kg 12 hours before operation,group B patients were treated with subcutaneous injec-tion of EPO 300 IU/kg 12 hours before operation,patients in group C( control group) had no treatment. All patients were detected myocardial zymetology after admission to hospital as well as 24 h,48 h,72 h after oper-ation. HSP70,ERK1/2 mRNA and protein expression in right auricle were detected by qRT-PCR and Western blot method,respectively. Results At each time point after operation,myocardial zymetology were signifi-cantly lower in group A and B compared with group C,the index of myocardial zymetology in group A were lower than that in group B(P<0. 05). The expressions of HSP70,ERK1/2 mRNA and protein were signifi-cantly up-regulated in group A and B compared to the control group(P<0. 05). The expressions of HSP70, ERK1/2 mRNA and protein in group A were significantly higher than those in group B ( P < 0. 05 ) . Conclusion EPO pretreatment has a positive effect on the myocardial protection during cardiopulmonary bypass. EPO may act a role of endogenous myocardial protection through up-regulation of the expressions of HSP70 and ERK1/2. The dosage of 150 IU/kg EPO is more significant on the effect of myocardial protection.
ABSTRACT
Objective To evaluate the protective effect of leukocyte-depleted warm blood cardioplegia on immature myocardium in infant.Methods Thirty infants with congenital heart disease whose American Society of Anesthesiologists(ASA) were Ⅱ-Ⅲ,aortic clamping time and bypass time were more than 30,40 minutes were respectively selected and divided into 2 groups:Experimental group and control group.Experimental group were perfused with leukocyte-depleted warm blood cardioplegia while control group perfused with common warm blood cardiplegia.Under monitoring the hemodynamics at surgery,the serum levels of troponin I(cTnI) and intercellular adhesion molecule-1(ICAM-1) in heparinized anticoagulant blood samples from radial artery at different time points [anesthesia induction and before extracorporeal circulation(T1),30 min after aortic clamping(T2) and aortic declamping 5 min(T3),15 min(T4)]were detected.Three pieces of cardiac muscle were taken from right atrium at different time points and the levels of myeloperoxidase(MPO) were detected.Results 1.The serum cTnI and ICAM-1 levels after aortic declamping were higher than those before operation,and the levels in experimental group were lower than those in control group(t=2.358,2.533,2.30,2.639 Pa