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目的探讨胎羊心脏转流对不停跳下胎羊心功能的影响。方法孕120～140 d 母羊8只,共孕9只胎羊,随机分为对照组(n=4)和胎羊体外循环组(CPB 组,n=5)。对照组胎羊开胸,不建立体外循环。CPB 组建立胎羊心脏转流模型,转流30 min。分别于转流前、转流30 min、转流结束后1 h、2 h测胎羊平均动脉压、心率和动脉血气值。观察血肌钙蛋白(TnI)含量的变化,B 超检测左、右心室 Tei 指数和脐动脉搏动指数(PI),观察心肌超微结构变化。结果两组胎羊平均动脉压、心率无显著变化。CPB 组胎羊脱离体外循环后出现高碳酸血症和酸中毒,血氧分压无显著变化。对照组胎羊血气值无明显变化。CPB 组胎羊左右心室 Tei 指数、脐动脉 H、血 TnI 含量均显著大于对照组(P<0.05)。CPB 组胎羊心肌细胞糖原明显减少。结论胎羊心脏转流对胎羊心功能造成损害,心功能不良与胎盘功能不良存在相互影响。
Objective To investigate the impact of fetal heart bypass on heart function of non-stop jumping sheep. Methods Eight pregnant women (120-140 d) were enrolled in the study. Nine fetuses were randomly divided into control group (n = 4) and fetal sheep extracorporeal circulation group (CPB group, n = 5). Control sheep fetus open chest, do not establish cardiopulmonary bypass. CPB group was established fetal heart bypass model, flow 30 min. The average arterial pressure, heart rate and arterial blood gas were measured before commutation, 30 min after commutation and 1 h and 2 h after commutation respectively. The changes of TnI level were observed. The left and right ventricular Tei index and the umbilical artery pulsatility index (PI) were detected by B ultrasound to observe the myocardial ultrastructure. Results The average arterial pressure and heart rate of the two groups of sheep did not change significantly. CPB fetus after leaving the cardiopulmonary bypass hypercapnia and acidosis, no significant changes in blood oxygen partial pressure. The control group fetus blood gas values did not change significantly. The contents of Tei index, umbilical artery H and blood TnI in fetal sheep in CPB group were significantly higher than those in control group (P <0.05). CPB group of sheep myocardial glycogen significantly reduced. Conclusion Fetal heart bypass may damage heart function of fetal sheep, heart dysfunction and placental dysfunction exist mutual influence.