吡那地尔超极化停搏对缺氧未成熟心肌保护的研究  

Protective Effects of Hyperpolarizing Cardioplegia with Pinacidil on Hypoxic Immature Myocardium

作　　者：王士忠[1] 刘立群[1] 隽兆东[1] 王忠伟[2] 陈维宁[2] 

机构地区：[1]潍坊医学院附属医院心胸外科,山东潍坊261042 [2]潍坊医学院临床机能实验室

出　　处：《潍坊医学院学报》2007年第5期409-412,I0002,共5页Acta Academiae Medicinae Weifang

摘　　要：目的探讨吡那地尔(Pinacidil)介导的超极化停搏对缺氧(紫绀型)未成熟心肌的保护作用。方法建立未成熟兔心肌慢性缺氧模型,18只缺氧幼兔随机分为超极化停搏液组(P组)、去极化停搏液组(S组),应用Langendorff非再循环离体心脏灌流技术,观察2组心脏机械停搏时间、复跳时间,心肌收缩力和冠脉流量恢复率,测量心肌匀浆上清丙二醛(MDA)、乳酸脱氢酶(LDH)、肌酸磷酸激酶(CK)含量,透射电镜下观察心肌细胞超微结构的变化。结果P组心肌收缩力和冠脉流量恢复率高于S组(P<0.05),而心肌LDH、CK含量较低(P<0.05),且再灌注后心肌超微结构改变较S组轻微,线粒体损伤小,心肌细胞超微结构得到较好保护;复灌早期P组有3例出现一过性室性心律失常,S组未发生严重室性心律紊乱。结论吡那地尔介导的超极化停搏对缺氧未成熟心肌的保护效果优于去极化停搏;复灌后早期一过性心律失常发生率较去极化停搏高,但可自动转复为正常心律。Objective To study the protective effects of hyperpolarizing cardioplegia wth Pinacidil on hypoxic immature myocardiuin in rabbits. Methods When the hypoxic model of neonatal rabbits established, 18 isolated hearts of 14 days immature rabbit were divided into two groups randomly：Pinacidil group（P group） and St. Thomas＇solution group（S group）. We perfused the isolated heart on modified Landgendorff apparatus, observed the experimental index, such as the time of heart arresting and the time of heart beating again,the revovery rate of contractility of myocardium and coronary blood effluent,MDA,LDH, CK and myocardial uhrastructure. Results The revovery rate of contractility and coronary blood effluent in P group was higher than that in S group （ P 〈 ft. 05 ） ,but the content of LDH and CK in P group was lower than that in S group（ P 〈 0.05 ）. The changes of the myocardium ultramierostrueture after reperfusion was lighter in P group, the damage of the mitochondrium was smaller,the uhramicrostrueture of myocardial cell in P group was preserved bitterly. There were 3 hearts occurred temporary ventricular arrhythmias in P group at the early time of reperfusion,but no heart occurred in S group. Conclusion The protective effects of hyperpolarizing cardioplegic solution with Pinacidil is superior to depolarizing cardioplegia on the hypoxic immature rabbit heart. The incidence rate of ventricular arrhythmias is higher at the early time of reperfusion,but this temporary ventricular arrhythmias itself easily recovered normal cardiac rhythm.

关 键 词：超极化停搏 心肌保护 缺氧未成熟心肌 去极化停搏 

分 类 号：R972.9[医药卫生—药品]