钠氢交换抑制剂与含钾通道开放剂的超极化停搏保存液合用对移植供心的保护作用  

Protective effect of hyperpolarized preservation solution combining sodium-hydrogen exchange inhibitor and potassium channel opener on donor heart

作　　者：彭昊[1] 李津[2] 胡英斌[2] 唐浩[2] 胡野荣[2] 周新民[2] 

机构地区：[1]第二军医大学长征医院胸心外科,上海200003 [2]中南大学湘雅二医院心胸外科,长沙410011

出　　处：《第二军医大学学报》2009年第6期663-667,共5页Academic Journal of Second Military Medical University

基　　金：湖南省自然科学基金(05JJ30052)~~

摘　　要：目的:探讨钠氢交换抑制剂(sodium-hydrogen exchange inhibitor,NHEI)能否加强含钾通道开放剂(potassium chan-nel opener,PCO)的超极化停搏保存液对移植供体心脏的保护作用,明确该组合对移植供心的保护程度。方法:在晶体液灌注的Langendorff模型上平衡30min后,兔心被分为4组:(1)Cel组:继续接受另一个30min的平衡灌注,用Celsior液停搏并保存8h然后再灌注1h;(2)Pin组:心脏用pinacidil(一种PCO)超极化液停搏并保存,余同Cel组;(3)Cel+Car组:第二个30min平衡期和再灌注时对心脏使用10μmol/L的cariporide(一种NHEI),余与Cel组相同;(4)Pin+Car组:心脏接受cariporide的处理和PCO超极化停搏并保存,余同Cel组。结果:Pin+Car组供心收缩功能恢复值显著高于Pin组[(87.4±11.9)%vs(69.0±7.2)%,P<0.05],达到Cel组水平[(93.4±5.2)%,P>0.05]。Cel组与Cel+Car组间各项指标均没有显著差异。各组间冠脉流量无显著差别。结论:NHEI能显著提高PCO超极化停搏液对移植供心的保护效果,二者联合使用的保护效果与Celsior液相当。Objective： To study whether sodium-hydrogen exchange inhibitor（NHEI）can enhance the protective effect of hyperpolarized preservation solution containing potassium channel opener （PCO）, and the effect was compared with that of Celsior solution. Methods： After equilibrated on a crystalloid-perfused Langendorff model for 30 min,rabbit hearts were divided into four groups： （1） Cel group： receiving another 30 min of equilibration, 8 h cold storage with Celsior solution and 1 h reperfusion ; （2） Pin group： arrested and stored with pinacidil （a type of PCO） byperpolarizing cardioplegia; （3） Cel ＋ Car group： receiving the same treatment as Cel group except that 10 μmol/L cariporide （a type of NHEI） was administered during the second equilibration period and reperfusion; and （ 4 ） Pin ＋ Car group： receiving cariporide treatment and hyperpolarized arrest and storage. Results： Recovery rate of systolic function in the Pin＋Car group was significantly higher than that in the Pin group （[87.4±11.9]% vs [69.0±7.2]%,P〈0.05） and comparable to that in the Cel group （[93.4±5.2]%,P〉0. 05 ）. No significant differences were found in any parameters between Cel group and Cel ＋ Car group. There were no differences in coronary flow among all groups. Conclusion： NHEI can greatly enhance the protective effect of PCO hperpolarized preservation solution on the donor heart, and the combination of them has a comparable protective effect to Celsior solution.

关 键 词：钠氢交换抑制剂 钾通道开放剂 心脏移植 心肌保存 

分 类 号：R654.28[医药卫生—外科学]