HTK停博液对未成熟兔心肌保护作用的研究  

Myocardial Protection of HTK Cardioplegia on Isolated Immature Rabbit Heart

作　　者：郑宏茹[1] 薛玉良[2] 

机构地区：[1]天津市儿童医院麻醉科,天津300070 [2]天津市泰达国际心血管医院麻醉科,天津300457

出　　处：《临床小儿外科杂志》2006年第1期37-41,共5页Journal of Clinical Pediatric Surgery

摘　　要：目的比较St.Thomas’Ⅱ(STH)停博液Histidine-Tryptophan-Ketoglutarat(eHTK)停博液对未成熟兔的心肌保护效果。方法取24只新西兰白兔,随机分为两组:A组即HTK幼兔组,n=12;B组即STH幼兔组,n=12。离体兔心,通过改良Langendorff装置灌注,观测左室收缩峰压(LVPSP),左室舒张末压(LVEDP),心率(HR),并收集冠状动脉引流液(CF),记录分钟流量,测定心肌酶CK、CK-MB的基础值。30min后,除各组随机选取2只兔心作为电镜超微结构的自身对照外,其余兔心经主动脉根部灌注4℃的STH液,每30min重复灌注1次或HTK液单次灌注,维持25℃恒温下心脏停博120min,然后以37℃的KH液复灌30min,观测各项心功能指标(同缺血前)。再灌注毕,留取标本做电镜观察及测定心肌丙二醛含量,测定剩余心肌组织干湿重。结果复灌30min后,LVPSP恢复百分比、LVEDP恢复百分比HTK液组好于STH液组(P<0.05);冠状动脉流出液心肌酶CK、CK-MB漏出液及心肌丙二醛含量HTK液组低于STH液组(P<0.05);电镜结果显示HTK液组的心肌细胞损伤较STH液组轻微。结论HTK液对未成熟心肌长时间停跳的心肌保护效果优于STH液。Objective To evaluate the myocardial protective effects of St.Thomas＇Ⅱ （STH） cardioplegic solution and Histidine-Tryptophan-Ketoglutatate （HTK） cardioplegic solution on the immature myocardium. Methods Hearts from immature New Zealand white rabbits （3-4 weeks, 440 to 540mg, n=24） were divided at random into two groups （groupA： HTKcardioplegia, n=12 and groupB： STH cardioplegia, n=12）. Animals were anesthetized and given heparin. The hearts were perfused by Langendorff perfusion apparatus. Coronary flow （CF）, systolic and diastolic left ventricle end pressure （LVPSP and LVEDP）, heart rate （HR） were recorded, and when perfused 30 minutes, 2 ml coronary effluent was used to the determination of CK and CK-MB leakage. After 30 minutes, two hearts elected from every group randomly were removed from the perfusion apparatus to observe the myocardial ultra structure. For others, aortic line was clamped and cardioplegia was infused into the coronary vasculature, Group A：infused HTK cardioplegia, Group B：infused STH cardioplegia at interval of 30 minutes. Global ischemia maintained for 2 hours at 25℃. After 2 hours, the hearts were reperfused by 37℃ KH solution for 30 minutes, during which time the recovery of cardiac function was assessed. At the end of each experiment the hearts were removed from the perfusion apparatus, some myocardium tissue was taken to weight the dried myocardium tissue, at the same time, we determined myocardial water content, the malondialdehyde （MDA） content in samples was also determined. Results After 2 hours ischemia, recovery of myocardium function. （1） Percent recovery of LVPSP and LVEDP in group A were significantly higher than those in group B（P〈0.05）.（2） Leakage of myocardial enzymes, CK and CK-MB activities in group A were significantly lower those in group B （P〈0.05）. （3） Water content, there was no difference between group A and B （（P〉0.05）. （4） MDA content in group A were lower than that in group B （�

关 键 词：HTK液 未成熟心肌 心肌保护 

分 类 号：R726.1[医药卫生—儿科]