常温有氧灌注保护心肌机理的实验研究  

Experimental study on myocardial protective mechanism of warmblood cardioplegia

作　　者：李彤[1] 刘维永[1] 谭红梅[1] 陈钢[1] 

机构地区：[1]西京医院心血管外科

出　　处：《第四军医大学学报》1995年第5期345-348,共4页Journal of the Fourth Military Medical University

摘　　要：作者通过建立细胞培养常温有氧停搏细胞模型，从更深层次揭示心肌缺血再灌注损伤机制及常温有氧灌注保护心肌机理．实验随机分为４组，各组均为８瓶培养细胞：①冷晶体心脏停搏液组；②冷血心脏停搏液组；③首末次温血停搏液，中间间歇应用冷血停搏液组；④温血停搏液组．结果：①Ⅰ组ＬＤＨ于恢复正常培养３０ｍｉｎ时明显升高并达到最高值．Ⅱ，Ⅲ组各期ＬＤＨ也升高（Ｐ＜０．０１），但明显低于Ⅰ组，而且Ⅲ组又优于Ⅱ组．Ⅳ组ＬＤＨ仅在恢复给氧３０ｍｉｎ时，较停搏前升高（Ｐ＜０．０５）．②心肌ＭＤＡ，ＳＯＤ的变化：Ⅰ组和Ⅱ组停搏１８０ｍｉｎ后ＭＤＡ即明显升高，ＳＯＤ则显著下降，复灌６０ｍｉｎ后二者进一步加重．Ⅱ组变化较Ⅰ组轻，Ⅲ组中ＭＤＡ，ＳＯＤ停搏１８０ｍｉｎ和停搏前相比，则无显著变化，仅于复灌６０ｍｉｎ出现变化（Ｐ＜０．０５）．Ⅳ组ＭＤＡ，ＳＯＤ于缺氧及复灌６０ｍｉｎ均无明显变化（Ｐ＞０．０５）．③心肌细胞内离子变化：４个组在停搏１８０ｍｉｎ心肌细胞内Ｃａ￣（２＋）和停搏前相比均无明显变化，而Ⅰ，Ⅱ，Ⅲ组于复灌６０ｍｉｎ均出现Ｃａ￣（２＋）超负荷（Ｐ＜０．０１），而Ｋ￣＋／Ｎａ￣＋在停搏１８０ｍｉｎ就明显降低，其中Ｃａ￣（２＋）超负荷?The mechanism of ischemia-reperfusion injury and the myocardial protective effect with warmblood cardioplegia in cultured myocardial cells of newborn rats were studied. The experiments were dividedcasually into 4 groups : Group Ⅰ, cold intermittent crystalloid cardioplegia group; Group Ⅱ, cold intermittentblood cardioplegia group; Group Ⅲ, initial and terminal warm blood cardioplegia with cold intermittent bloodcardioplegia group; Group Ⅳ, warm continuous blood cardioplegia group. The results showed :( 1)In thegroupⅠ, the release of LDH remarkedly rose and reached the peak value at reperfusion 30 min; In both thegroup Ⅱ and group Ⅲ, compared with LDH of group Ⅰ, enzymological parameters remarkably decreased.Furthermore, the decline was more significant in group Ⅲ than in group Ⅱ; In the group Ⅳ, LDH rose onlyat reperfusion 30 min(P<0. 05).(2)Changes of MDA and SOD in myocardial cells : myocardial cells MDAwere increased and myocardial cells SOD were decreased at arrest 180 min and progressive changes at reperfu-sion 60 min in group Ⅰ and group Ⅱ. MDA and SOD changes in myocardial cells were found only at reperfu-sion 60 min in group Ⅲ and no significant changed during whole period experiment in group Ⅳ. (3)Changesof myocardial cells ions : In groups Ⅰ,Ⅱ and Ⅲ, Ca￣(2+) overload have just occured at reperfusion 60 min,but, the ratio values K￣+/Na￣ + have declined at arrest 180 min, Ca￣(2+) overload and ratio of K￣+/Na￣+ decreasewere most serious in group Ⅰ less in group Ⅱ, and least in group Ⅲ. Group Ⅳ showed no significant Ca￣(2+)overload and decrease of K￣+/Na￣+. The changes of ratio of K￣+/Na￣+ at arrest 180 min were negative linear re-lationship to that Ca￣(2+) content at reperfusion. The results suggest that Na￣+ overload may play an importantrol

关 键 词：心肌保护 停搏液 温血灌注 常温有氧灌注 大鼠 

分 类 号：R654.1[医药卫生—外科学]