氨基酸强化温血诱导及再灌注对未成熟心肌保护的实验研究  

Experimental study on immature myocardial protection with warm induction and reperfusion of amino acid enriched blood cardioplegia

作　　者：陈惠文[1] 苏肇伉[1] 陈恩[1] 祝忠群[1] 黄惠民[1] 俞小青 

机构地区：[1]上海第二医科大学附属新华医院心胸外科,200092

出　　处：《上海医学》1998年第4期203-205,共3页Shanghai Medical Journal

基　　金：国家自然科学基金资助项目 !(编号 39570 697)

摘　　要：目的 :为研究氨基酸强化温血停搏液诱导停跳和主动脉开放前再灌注对未成熟心肌保护的效果。方法 :18只新西兰幼兔 ( 3～ 4周 ,体重 0 .4 5～ 0 .55kg) ,随机分成 3组。 组 :冷血停搏液组 ( n=6) ; 组 :温血诱导及再灌注血停搏液组 ( n=6) ; 组 :温血诱导及再灌注血停搏液加天门冬氨酸和谷氨酸强化组 ( n=6)。于缺血前后测定心功能、复灌后取心肌组织作含水量测定和心肌结构电镜观察 ,收集冠脉液作心肌酶测定。结果 :( 1)心功能 :AF,CF,CO,LVSP和±dp/ dt恢复百分率 : 及 组明显优于 组 ( P<0 .0 1) ;L VDP,HR恢复百分率各组间无差异 ( P>0 .0 5) ;( 2 ) L DH和 CK漏出量 ( U/ L) ; 及 组明显优于 组 ( P<0 .0 1) ;( 3)心肌含水量 ( % ) 及 组明显优于 组 ( P<0 .0 1) , 组优于 组( P<0 .0 1) ;( 4 )心肌结构保护 : 及 组明显优于 组。本实验提示 :温血诱导停跳与主动脉开放前温血再灌注对于未成熟心肌有良好的保护效果 。Objective:To examine the myocardial protection of warm induction before clamping and reperfusion,be- fore clamp- releasing ofamino acid enriched blood cardioplegia in immature heart.Methods :Eightten Newzeland rabbits (aged3to4weeks,weight0 .45～ 0 .5 5 Kg) were divided randomly into three groups:Group .cold blood cardioplegia (4℃ ,n=6 ) ;Group ,warm induction and reperfusion of blood cardioplegia(n=6 ) ;Group ,warm induction and reperfusion with aspartate(2 0 mmol/L) and glutam ate(2 0 mmol/L) - enriched blood cardioplegia(n=6 ) .Percentrecov- ery of heart function before and after ischemia:CK,L DH release,water content and myocardial structure were assessed after reperfusion among the three groups.Results:1.percent recovery of AF,CF,CO,L VSP and± dp/dt:in group and ,were better than those of Group (P<0 .0 1) ;2 .L DH and CK release(U/L) :in group and These were, less than that in those in Group (P<0 .0 1) ;3.myocardial water content(% ) ;in group and it wae less than Group (P<0 .0 1) ;in group also less than that in Group (P<0 .0 1) ,Group vs Group (P<0 .0 1)。 4.pro- tection of myocardial structure was betten in Group and than in Group .Conclusion :Technique of warm induc- tion and reperfusion afford an excellent myocardial protection,but further study ahould be done to be certain of the use- fulness of amiono acid in the blood cardioplegia.

关 键 词：血停搏液 氨基酸 温血诱导 心肌保护 

分 类 号：R542.2[医药卫生—心血管疾病] R977.4[医药卫生—内科学]