硒对心肌缺血/再灌注期间冠状静脉窦血中红细胞流变性的保护作用  

Protective effect of selenium on human erythrocyte rheology

作　　者：黄益民[1,2] 韩玲[1,2] 郭金良[1,2] 虞欣[1,2] 李勇[1,2] 顾云[1,2] 金鸣[1,2] 陈宝田[1,2] 

机构地区：[1]北京心肺血管疾病研究所 [2]清华大学分析中心

出　　处：《中华医学杂志》1998年第2期101-104,共4页National Medical Journal of China

基　　金：国家自然科学基金;北京市自然科学基金

摘　　要：目的观察硒对人心肌缺血／再灌注期间冠状静脉窦血中红细胞流变性的保护作用。方法对术前口服硒的患房间隔缺损和室间隔缺损病人在行体外循环心内直视修补术中心肌缺血／再灌注期间的冠状静脉窦血中维生素Ｃ自由基水平（Ａ·）、脂质过氧化物（ＭＤＡ）、自由基清除酶活性（ＳＯＤ和ＧＳＨ－Ｐｘ）、红细胞膜剪切弹性模量（μ）和细胞表面指数（Ｓｉ）、红细胞膜脂质分子（τ１））及蛋白分子（即τｐ）相对旋转时间等指标进行了动态观察，并与术前未服硒的对照组进行比较。结果再灌注后即刻，尽管服硒组Ａ·的增加幅度与对照组基本相同（６６％比６８％），但从再灌注５分钟后服硒组的Ａ·水平降低到对照组相应时间的５０％左右，并于再灌注２０分钟时基本恢复到缺血前水平，与此同时服硒组ＭＤＡ和红细胞ＧＳＨ－Ｐｘ活性的增加幅度也只相当于对照组的一半左右；再灌注后对照组的红细胞μ值、膜分子的τｌ和τｐ值都发生了特征性改变或明显变化，而服硒组除了再灌注５分钟时的红细胞膜τｐ值显著增高外（其改变幅度稍高于对照，＋１６％比＋１４．３％），μ值和τ１值均无特征性变化。结论术前口服硒可有效保护在心内直视手术中心肌缺血／再灌注期间红细胞流变性免受自由基的损伤。Objective To assess the protective effect of selenium on RBC rheology during myocardial ischemia/reperfusion period in patients with VSD or ASD who underwent cardiopulmonary bypass. Methods The blood samples were taken from the coronary sinus, and ascorbyl free radical (A·), peroxidants (MDA), antiperoxidative activities (plasma SOD, erythrocyte GSH Px), the membrane shear elastic module of RBC (μ), molecular rotational correlation times of lipids and proteins of RBC membrane (τl, τp) were measured and compared between control and selenium groups. Results After myocardial reperfusion only for one minute, in both groups A · was significantly increased (The increased percentage in the control group +68%, in the selenium group +66% ), but the selenium group had lower MDA and GSH Px activity. On contrary to the control group with high A · level, A · of the selenium group was dropped about half since reperfusion for 5 minutes and recovered to the pre ischemia level. After myocardial reperfusion, the control group had specific changes in membrane μ values as well as evidently prologed τl and τp. Simultaneously, except τp at 5 minutes of reperfusion was obviously prolonged, no changes in the membrane μ and τl were observed in the selenium group during the cardiac ischemia/reperfusion periol. Conclusion Selenium can at least partly protect RBC rheology from free radical damage during the myocardial ischemia/reperfusion period.

关 键 词：硒 心肌缺血 再灌注 红细胞流变学 

分 类 号：R654.1[医药卫生—外科学] R542.2[医药卫生—临床医学]