超极化停搏对体外循环中心肌细胞膜微粘度变化的影响  

Effect of hyperpolarized arrest on alternations of microviscosity of myocardial cell membrane during cardiopulmonary bypass

作　　者：曾志勇[1] 陈龙[1] 王志农[2] 徐志云[2] 庄聪文[1] 杨胜生[1] 张娟[1] 张宝仁[2] 

机构地区：[1]解放军南京军区福州总医院心胸外科,福州350025 [2]上海第二军医大学长海医院胸心外科,上海200433

出　　处：《中国胸心血管外科临床杂志》2004年第3期204-206,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：福建省自然科学基金资助项目(C0110026)~~

摘　　要：目的　比较超极化停搏和去极化停搏对体外循环 (CPB)中心肌细胞膜流动性变化的影响 ,评价超极化停搏液的心肌保护作用。　方法　根据随机数字表法将 72只家猫均分为 3组 ,每组 2 4只。对照组 :不阻断上、下腔静脉和主动脉 ,仅行并行循环 180分钟 ;去极化停搏组 :阻断主动脉 6 0分钟 ,再灌注 90分钟 ,心脏停搏液使用 St.Thomas液 (K+ 16 mm ol/ L ) ;超极化停搏组 :心脏停搏液使用含吡那地尔的 St.Thomas液 (K+ 5 mmol/ L ) ,其余处理与去极化停搏组相同。应用荧光偏振法测定心肌细胞膜的微粘度 (η) ,以 η的倒数表示心肌细胞膜流动性。　结果　去极化停搏组主动脉阻断期间心肌细胞膜η值明显上升 ,且于再灌注期间进一步升高 ;超极化停搏组主动脉阻断期间亦呈升高趋势 ,但各时间点 η值均明显低于去极化停搏组 (P<0 .0 1)。　结论　超极化停搏比去极化停搏能更有效地维持 CPB中缺血 -再灌注心肌细胞膜的流动性 。Objective To observe the influences of depolarized arrest and hyperpolarized arrest on alternation of fluidity of myocardial cell membrane during cardiopulmonary bypass (CPB) and evaluate the protective effects on myocardium of hyperpolarized arrest. Methods Seventy-two felines were randomized into three groups, each group 24. Control group: 180 minutes of CPB was conducted without aortic and vena caval cross-clamping. Depolarized arrest group: hearts underwent 60 minutes of global ischemia after aortic cross-clamping (ACC) followed by 90 minutes of reperfusion. The cardioplegic solution consisted of St. Thomas solution (K^+16mmol/L). Hyperpolarized arrest group: the protocol was the same as that in depolarized arrest group except that the cardioplegic solution consisted of St.Thomas solution with pinacidil (50 mmol/L,K^+5mmol/L). Microviscosity, the reciprocal of fluidity of myocardial membrane was measured in all groups by using fluorescence polarization technique. (Results )Microviscosity of myocardial cell in depolarized arrest group during ACC period was significantly higher than that before ACC and kept on rising during reperfusion period. Microviscosity of myocardial cell in hyperpolarized arrest group during ACC was trending up and reperfusion periods as well, but markedly lower compared to that in depolarized arrest group at corresponding time points(P<0.01). Conclusion Hyperpolarized arrest is more effective in protecting myocardial cells from ischemia-reperfusion injury than depolarized arrest during CPB by maintaining better fluidity of myocardial membrane.

关 键 词：超极化停搏 体外循环 心肌细胞膜 微粘度 CPB 缺血-再灌注损伤 膜流动性 钾通道 

分 类 号：R654.1[医药卫生—外科学]