羟乙基淀粉对大鼠心肌缺血-再灌注损伤的保护作用  

Protective effect of Hydroxyethyl starch against myocardial ischemia-reperfusion injury in rats

作　　者：孙海静[1] 石学银[1] 徐海涛[1] 王亚华[1] 朱秋峰[1] 刘刚[1] 

机构地区：[1]第二军医大学附属长征医院麻醉科,上海市200003

出　　处：《临床麻醉学杂志》2008年第7期608-610,共3页Journal of Clinical Anesthesiology

基　　金：全军医药卫生科研基金(编号:03MA004)

摘　　要：目的观察羟乙基淀粉(HES130/0.4,万汶)对大鼠心肌缺血-再灌注损伤的保护作用。方法46只SD大鼠随机分为缺血-再灌注组(IR组,n=12)、白蛋白-缺血-再灌注组(A-IR组,n=12)、羟乙基淀粉-缺血-再灌注组(V-IR组,n=12)和假手术组(S组,n=10)。IR、A-IR和V-IR组分别在缺血25 min时静脉持续泵入生理盐水、5%白蛋白和羟乙基淀粉(HES130/0.4),于缺血前、缺血30min以及再灌注60、120、180 min时,测定HR、MAP、左室收缩峰压(LVSP)、左室内压变化最大速率(±dp/dtmax)以评价心肌功能。再灌注180 min处死大鼠行TTC染色法测定心肌梗死面积及髓过氧化物酶(MPO)活性并观察心肌组织病理学改变。结果缺血30 min、再灌注60、120和180 min,V-IR组HR、MAP、LVSP和±dp/dtmax的绝对值均较IR组和A-IR组升高(P<0.05)。V-IR组心肌梗死面积明显比IR组和A-IR组减小(P<0.05)。再灌注后,IR、A-IR和V-IR组MPO活性显著高于S组(P<0.05),但V-IR组MPO活性较IR组和A-IR组有所降低(P<0.05),IR组和A-IR组MPO活性比较差异无统计学意义。心肌病理学切片示V-IR组病理学变化较IR组和A-IR组减轻。结论羟乙基淀粉对缺血-再灌注损伤的心肌组织具有保护作用,能促进心功能恢复,其机制可能与羟乙基淀粉抑制缺血-再灌注时中性粒细胞的激活和浸润有关。Objective To observe the protective effect of hydroxyethyl starch 130/0. 4 （HES130/0.4） against myocardial ischemia-reperfusion（I/R） injury in rats. Methods Forty-six SD rats were randomly divided into four groups： sham operation group （S）, ischemia-reperfusion group （IR, treated with 7.5 ml/kg saline）, albumin-ischemia-reperfusion group （A-IR, treated with 7.5 ml/kg 50/ albumin） and HES-ischemia-reperfusion group（V-IR, treated with 7.5 ml/kg HES130/0.4 ） via jugular vein at ischemia 25 min. HR,MAP,LVSP and ±dp/dtmax were recorded at ischemia 30 min, reperfusion 60,120 and 180 min. Myocardial infarct size was determined by 2,3,5-triphenyltetrazolium chloride （TTC） staining method. The changes of activity of MPO and histopathology were examined. Results At ischemia 30 min,reperfusion 60,120 and 180 min,V-IR group significantly increased HR, MAP,LVSP and ±dp/dtmax compared with group IR and A-IR （P〈0.05）. Myocardial infarct size in V IR group was significantly smaller as compared with group IR and A-IR （P〈0.05）.The activity of MPO was increased significantly in the IR,A-IR and V-IR groups compared with S group （P〈0.05）, which was decreased significantly in V-IR group compared with that in the IR and A-IR groups （P〈 0. 05）. Histological examination showed that the degree of injury in group V-IR was significantly ameliorated compared with that in group IR and A-IR. Conclusion HES130/0.4 could improve myocardial function and attenuate ischemia-reperfusion injury,and the mechanism may be inhibition of the infiltration of polymorphonuclear neutrophils.

关 键 词：羟乙基淀粉 再灌注损伤 心肌保护 中性粒细胞 

分 类 号：R96[医药卫生—药理学]