浅低温对麻醉兔急性缺血再灌注心肌作用的研究  

Effect of mild hypothermia on acute ischemia-reperfusion myocardium of anesthetized rabbits

作　　者：吴有华[1] 任江华[1] 曹茂银[1] 邵玲[1] 

机构地区：[1]武汉大学中南医院心内科,湖北武汉430071

出　　处：《中国老年学杂志》2005年第4期421-424,共4页Chinese Journal of Gerontology

基　　金：湖北省卫生厅资助项目(301140323)

摘　　要：目的探讨低温对麻醉兔急性缺血再灌注心肌的作用。方法采用麻醉开胸结扎/松开家兔左冠状动脉前降支制作急性缺血再灌注模型,32只动物随机分成5组Ⅰ空白组(n=6);Ⅱ对照组(n=7);Ⅲ物理低温组(n=6);Ⅳ氯丙嗪组(n=6);Ⅴ氯丙嗪+物理低温组(n=7)。其中Ⅱ～Ⅴ均结扎30min,再灌注2h。动态监测体温及血流动力学参数,Evens蓝和TTC双重染色计算心肌梗死范围(MI/RISK),再灌注末留缺血梗死区心肌观察超微结构变化。结果在降温后的各时间点,Ⅲ和Ⅴ的体温、HR、LVSP及±dp/dtmax均低于其他组(P<0.05),但它们之间无显著差异(P>0.05),Ⅲ、Ⅳ、Ⅴ的MI/RISK分别比Ⅱ减少35.0%、17.4%和45.9%(P<0.05),且Ⅴ低于Ⅲ和Ⅳ(P<0.05)。Ⅲ和Ⅴ电镜下心肌超微结构损伤轻于Ⅱ组。结论①低温对麻醉兔急性缺血再灌注心肌有一定保护作用;②氯丙嗪+物理低温组的保护效果优于物理低温组可能与药物本身的作用有关。Objective To investigate the effect of mild hypothermia on ischemia-reperfusion myocardium of anesthetized rabbits. Methods Acute ischemia-reperfusion model was made by ligation/de-ligation of anterior descending branch in coronary artery on anesthetized rabbits. 32 rabbits were randomly divided into 5 groups,Ⅰ(shame operated group, n=6);Ⅱ(control group, n=7),Ⅲ(physical hypothermia group, n=6);Ⅳ(chlorpromazine group, n=6) andⅤ(chlorpromazine + physical hypothermia group, n=7). The rabbits in Ⅱ、Ⅲ、Ⅳ and Ⅴ were ligated for 30 min and reperfused for 2 h. Body temperature and hemodynamic parameters were dynamically monitored, myocardial infarction size was determined by means of double-dyed (Evens and TTC) and the change of myocardial ultralstructure was examined in ischemia infarct region at end of reperfusion. Results Baseline level of body temperature, HR, LVSP and ±dp/dt_~max in Ⅲ and Ⅴ were lower than those in the other groups (P<0.05), but without differences between these two groups (P>0.05). The infact size of Ⅲ、Ⅳ and Ⅴ separately less than that of Ⅱ by 35.0%, 17.4% and 45.9% (P<0.05), also that of Ⅴ was smaller than that of Ⅲ and Ⅳ(P<0.05). The myocardial ultrastructural damage found under electron microscope in Ⅲ and Ⅴ were less than that of Ⅱ. Conclusions ①Mild hypothermia could protect acute ischmia-reperfusion myocardium in anesthetized rabbits. ②The protective effect inⅤgroup better than that of Ⅲ group may be due to the action of chlorpromazine itself.

关 键 词：低温 缺血再灌注 心肌 

分 类 号：R541.1[医药卫生—心血管疾病] R454.5[医药卫生—内科学]