腺苷预处理对大鼠离体心脏长期保存的心肌保护作用  

Effects of adenosine preconditioning on myocardium preservation of long term isolated rat heart

作　　者：忻元峰[1] 汪进益[1] 刘中民[1] 范慧敏[1] 刘泳[1] 张涛[1] 

机构地区：[1]同济大学附属东方医院心胸外科,上海200120

出　　处：《同济大学学报（医学版）》2008年第2期28-31,共4页Journal of Tongji University(Medical Science)

摘　　要：目的观察腺苷预处理对大鼠离体心脏长期保存的心肌保护作用。方法将24只健康雄性SD大鼠随机分为4组,每组6只,分成空白对照组、预处理组、保存组和预处理后保存组。离体大鼠心脏用Langendorff装置灌注稳定后,分别给予腺苷预处理后再灌注、心脏保存24 h后再灌注及腺苷预处理后再经24 h保存后再灌注60min,观察左室收缩功能的恢复率、冠脉回流液中肌酸肝激酶(creatine kinase,CK)、乳酸脱氢酶(lactate dehydrogenage,LDH)的浓度以及心肌形态结构改变。结果预处理组同空白对照组相比,各项指标差异无显著性(P>0.05)。单纯保存组同对照组相比,左室收缩功能明显减弱,冠脉回流液中心肌酶的漏出明显增加,光镜及电镜观察心肌损伤严重。而经腺苷预处理后再保存组,左室收缩功能的恢复率较单纯保存组有明显提高52.1%±7.4%vs35.9%±4.8%,P<0.05,心肌酶漏出明显减少[CK:(302±42)IU/Lvs(632±118)IU/L;LDH:(28±8)IU/Lvs(78±11)IU/L,P<0.05],光镜及电镜观察,心肌损伤程度明显减轻。结论腺苷预处理过程本身对心肌细胞无明显损伤,是比较安全的;腺苷预处理对离体心脏长期保存有明显的保护作用。Objective To study the effects of adenosine （Ado） preconditioning on myocardium preservation of long term isolated rat heart. Methods Twenty-four male Sprague-Dawley （SD） rats were randomly divided into 4 groups：control group, preservation group, Ado group and Ado-preservation group. In the group Ado and Ado-preservation group, the hearts were then arrested and preservated for 24 h with St.. Thomas＇ cardioplegic solution at 4℃, followed by 60 min normothermic reperfusion. As controls, hearts were perfused continuously for 60 min without being preservated in both control group and preservation group. Recovery of left ventricle contractive function, concentration of creatine kinase （CK） and lactate dehydrogenase （LDH） and morphologic changes of myocardium were compared indifferent groups. Results Data in preservation group had no significant differences as compared with those in control group （ P 〉 0.05 ）. Hearts in the preservation group showed dysfunction and injury to various degrees than the hearts in control group. But the hearts undergoing preconditioning in Ado-preservation group showed better recovery of left ventricular developed pressure [ （52.1 ± 7.4 ） % vs （ 35.9 ± 4.8 ） % , P 〈 0.05 ], less leakage of enzymes [ CK： （302 ± 42 ） IU/L vs （632 ±118 ） IU/L; LDH： （ 28 ± 8 ） IU/L vs （78 ± 11 ） IU/L, P 〈 0.05 ] , and also less injury by electron microscopy than those in preservation group. Conclusion Adenosine preconditioning can protect isolated rat heart from injury caused by long term cold storage, which demonstrates that adding adenosine in cardioplegic solution is safe in myocardial protection and heart preservation.

关 键 词：腺苷 心脏保存 心肌保护 大鼠 

分 类 号：R365.654[医药卫生—病理学]