缺血预处理与心麻液结合对离体大鼠心脏缺血再灌注损伤的保护  

Protective Effects of Ischemic Preconditioning with Normothermia orHypothermia on Reperfusion Injury in IsolatedRat Hearts

作　　者：陈胜喜[1,2] 殷桂林[1,2] 袁明道[1,2] 张殿堂 鲁尔雄 

机构地区：[1]湖南医科大学湘雅医院胸心外科 [2]广州军区武汉总医院胸心外科

出　　处：《中华胸心血管外科杂志》1997年第2期110-112,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：湖南省科委自然科学基金

摘　　要：采用离体大鼠心脏Ｌａｎｇｅｎｄｏｒｆｆ灌注模型，停止灌注造成缺血，观察３７℃和３０℃条件下单次５分钟、缺血１０分钟再灌注所形成的缺血预处理，对持续１８０分钟缺血、４５分钟再灌注的心肌保护作用。持续停跳期间每３０分钟经主动脉根部灌注Ｓｔ．Ｔｈｏｍａｓ晶体心麻液。实验发现，常温下缺血预处理与晶体心麻液相结合对离体大鼠灌注心脏缺血再灌注损伤的保护作用呈累加现象；低温下缺血预处理使预处理的心肌保护作用减弱。这可能与心脏停跳的的快速降温有关；能量消耗减少和细胞结构的保护可能是预处理的机制之一。This is a study on protective effects of i.hermcpremnditionit.withnonmothe.a(NP)orltpothemda (HP) on reperfusion injuries of myocardium in isolated rat hearts. Observattonwasmadeon rat heartsperfusxlona ltanaen- dorff apparatus. Two gtnups of isolated rat heuts were separately subjected to ischemia for 5 ndnutes under nomothermda (37 )and hypothenrua (301C )before 180 mdnute. The isolated normothennic(NC) and hypothemic(HC) rat hearts with- out ischemic preonnditioning served as control grous. Heam functional data were coUemed . Enzyrne and ATP clteng. were in- vestigntol uwl taltr.tructural alterations in the myacardiurn were examdned. The r.ults indicated that reooverv of left ventric- ular function, in terms of LVP, dp/dt max and -dp/dt max.was very much better in NP tlan in liP (P<0.01) and wu narkedly improved in NP as compued with NC and HP (P<0.01)after 45 minute reperfusion.There was no significant dif- fercnce betteen NC and liP although the urdia. functional indices in liP were sltghtly better ttan NC. Th. incidence of ar- rhytltmia (mainly ventricular fihnllation and premature ventncular beats) was 0 in both NP and HP , and was markedly higher in both NC and HC (P<0.01 ).Enzyme leakage (CK,LDH,GOT) of the myourdium after45mdnutereperfusionwasin- creased in all groups as compared with their control value, but the amplitude of increase was very much lower in I4P and llP than in NC and HC(P<0.01). The ATP content of the myocarrdium was very markedlyhigherinNPt.NCandHP(P <0. 01 ) . Ultrastructural changes of myocardiunn was verv slight in NP and IIP as compared with NC and HC. The changes were less in NP than in HP. The author conclude that ischemic preconditioning definitely offers protective effects against reperfusion injury to the myocardium Hypothemia seems to decrease the protective effect. of the ischemic preconditioning.

关 键 词：IP 心肌保护 晶体麻液 心肌麻血 再灌注损伤 

分 类 号：R542.2[医药卫生—心血管疾病] R654.1[医药卫生—内科学]