艾司洛尔作为停搏液对离体猪心保护作用的实验研究  

Myocardial protection with esmolol as cardioplegia to isolated pig heart

作　　者：伍火志[1] 袁茂溪[1] 罗常进[1] 刘鑫[1] 袁江[1] 

机构地区：[1]遵义医学院第五附属(珠海)医院心胸外科,广东珠海519100

出　　处：《海南医学》2009年第8期13-16,共4页Hainan Medical Journal

基　　金：广东省珠海市科技局课题:珠科[2005]21号

摘　　要：目的探讨艾司洛尔作为停搏液对离体猪心的保护作用及可能的机制。方法建立Langen-dorff猪离体心脏灌注模型。健康家养猪18头,雌雄不拘。随机分为KHB组(KHB液组)、ST组(St.ThomasⅡ停搏液)、ES组(艾司洛尔组),每组6只。开胸立即取出心脏,置于Langendorff灌注装置上,用充氧的KHB液平衡灌注20min后,分别用两种不同的停搏液[艾司洛尔1mmol/L+(95%O2+5%CO2)和St.ThomasⅡ]液灌注,每隔10min灌注一次,灌注压为75mmHg(1mmHg=0.133Kpa),温度37°C,时间为60min。停止停搏液灌注后,即恢复KHB再灌注60min。连续监测血流动力学的变化。在KHB灌注20min和KHB再灌注30min后记录心率(HR)。在KHB灌注20min、停搏液灌注30min、60min和KHB再灌注30min后留取5ml的灌注液检测心肌肌酸激酶同功酶(CK-MB)、肌钙蛋白I(cTnI)。KHB液再灌注60min后切取两小块心肌组织分别用于测湿干重比和测定ATP含量。结果KHB灌注20min时各组之间比较,心率无统计学意义(P>0.05);再灌注30min后,KHB组的心率明显低于ST组和ES组(P<0.05)。ES组心肌含水量、CK-MB、cTnI和左心室舒张末压(LVEDP)均明显低于KHB组(P<0.05);而冠状动脉流量(CF)、心肌组织中ATP含量均显著高于KHB组(P<0.05)。ES组与St.ThomasⅡ组相比,上述指标的变化差异无统计学意义(P>0.05)。结论艾司洛尔可作为停搏液对离体猪心有良好的保护。Objective To investigate the myocardial protection with esmolol as a eardioplegia to isolated pig heart and its possible mechanisms. Methods The model of isolated perfusion of pig heart was adopted Langendorff model. 18 healthy pigs were randomly allocated to KHB group （KHB group） 、ST group （St. Thomas Ⅱ group ） and ES group （oxygenated esmolol group） （n = 6 , every group）. The heart was immediately took out after thoraeotomy and placed on Langendorff perfusion device. 10 ml cardioplegia was infused every 10 min, and this procedure was continued for 60 min, then parallel circulation was followed for 120 min. Hemodynamics were measured continuously, 5 ml of blood samples was obtained at 5 min 、115 min and at the end of reperfusion, respectively. The serum was collected to detected CK - MB, eTnI. The wet to dry weight ratio （W/D） and ATP content in the myo- eardium were also measured at the end of the experiment. After reperfusion 20 rain with the balance of liquid oxygen KHB, continuous cardioplegia perfusion [ Oxygenated esmolollmmol/L ＋ （95% O2 ＋ 5% CO2 ） and St. Thomas Ⅱ （ST） ] was made with 75mmHg of the perfusion pressure at 37 ℃ for 60min. After cessation of infusion, KHB reperfusion was adopted for 60 min. Hemodynamics were measured continuously. Results The levels of water content of the heart, CK - MB and cTnI became significantly lower in ES group than those in KHB group（P 〈0. 05） , ATP content in the myocardium was higher in ES group than that in KHB group（P 〈0. 05） while no difference between ES group and ST group. Conclusions Like St. Thomas Ⅱ cardioplegia, esmolol as a kind of cardioplegia has better protection to isolated pig heart.

关 键 词：艾司洛尔 停搏液 心肌保护 猪心 

分 类 号：R-33[医药卫生]