糖尿病大鼠离体心脏对缺血/再灌注的耐受性  

Increased tolerance to ischemia/ reperfusion injury in isolated diabetic rat hearts

作　　者：刘涛[1] 徐美英[2] 都大伟[1] 尹尧[1] 张玉良[1] 陈红[3] 

机构地区：[1]解放军451医院麻醉科,西安市710054 [2]上海市胸科医院麻醉科 [3]上海第二医科大学药理教研室

出　　处：《中华麻醉学杂志》2005年第2期126-129,共4页Chinese Journal of Anesthesiology

基　　金：国家973项目基金资助(G200005695)

摘　　要：目的评价糖尿病大鼠离体心脏缺血／再灌注后心脏功能的改变。方法链佐星(60mg／kg)诱导的糖尿病大鼠16只(D组),年龄匹配的健康雄性SD大鼠10只(C组),戊巴比妥钠(60mg／kg)麻醉后快速取出心脏,接上主动脉插管置于Langendorg装置上,Krebs-Henseleit缓冲液逆行灌注。平衡灌注20min,待心率(HR)及冠脉流量平稳后夹闭灌注道,进行全心缺血30min,复灌40min。持续监测心肌心电活动、左心室压峰值(LVPSP)、左室舒张末压(LVEDP)和左室压力最大上升／下降速率(±dp／dtmax),计算左室发展压(LVDP=LVPSP-LVEDP),用LVDP×HR(RDPP)表示左室作功。结果与C组相比,基础状态下,D组大鼠心脏HR减慢,LVDP、RDPP和±dp／dtmax降低,LVEDP升高(P<0.05或0.01);再灌注后HR、LVDP、RDPP、冠脉流出液、±dp／dtmax等心功能指标恢复百分率升高,肌酸激酶活性降低(P<0.05或0.01);心脏缺血-停搏时间延长。结论糖尿病心脏基础心功能损伤严重,但对缺血／再灌注的耐受性增强。Objective To evaluate the tolerance to ischemia-reperfusion (I/R) injury in isolated diabetic rat hearts.Methods Thirty male 8-week old SD rats weighing 250-270 g were randomly divided into 2 groups: control group (C, n = 10) and diabetic group (D, n - 20) . Diabetes mellitus was induced by intraperitoneal streptozotocin (STZ) 60 mg·kg Diabetes mellitus was defined as persistent blood glucose levels 16.7 mmol· L-1 . Four weeks after STZ injection the animals were anesthetized with intraperitoneal pentobarbital 60 mg·kg-1. The hearts were immediately removed and perfused with oxygenated (95% O2 , 5% CO2 ) K-H solution in a Langendorff apparatus at a constant pressure of 80 mm Hg. After 20 min epuilibration all hearts were subjected to 30 min global ischemia followed by 40 min reperfusion. HR and epicardial ECG were monitored. Left ventricular peak systolic pressure (LVPSP), left ventricular end-diastolic pressure (LVEDP) and ± dp/dt were measured and recorded using computerized data acquisition system throughout the experiment. Left ventricular developed pressure (LVDP) ( = LVPSP - LVEDP) and left ventricular work ( LVDP × HR) were calculated. Coronary outflow was collected during reperfusion for determination of creatine kinase (CK) release. Results The body weight and heart weight were significantly lighter in group D than in group C ( P < 0.01 or0.05), but there was no significant difference in the relative heart weight (heart weight/body weight) between the two groups. The baseline HR, LVDP, left ventricular work and ± dp/dtmax were significantly lower while LVEDP was significantly higher in group D than in group C ( P < 0.01 or 0.05) . The ischemia-arrest time was significantly longer in group D L (1 450 ± 320) sj than in group C [ (235 ±51) s] (P < 0.01). Cardiac function recovered better after reperfusion in group D than in group C (P < 0.01 or 0.05) in terms of HR, LVDP, left ventricular work, coronary outflow and ± dp/dtmax . The CK release during reperfusion was less in group D than in group C.

关 键 词：糖尿病大鼠 缺血/再灌注 耐受性 离体心脏 Langendorff 心率(HR) 左室舒张末压 LVDP 心脏缺血 0.05 戊巴比妥钠 主动脉插管 LVEDP 冠脉流出液 心功能指标 心功能损伤 心脏功能 SD大鼠 逆行灌注 平衡灌注 冠脉流量 全心缺血 

分 类 号：R587.1[医药卫生—内分泌] R654.1[医药卫生—内科学]