心脏保存液种类及保存时间对离体鼠心低温保存效果的对比研究  

Comparative study of different preservatives for preservation of isolated nurine heart under low temperature

作　　者：郑岩[1] 李伯君[2] 李力兵[2] 马兰[2] 

机构地区：[1]解放军第309医院危重症监护科,北京100091 [2]解放军总医院心血管外科

出　　处：《解放军医学杂志》2010年第1期48-51,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的研究3种心脏保存液[HTK液、FWM液和St.Thomas-Ⅱ(ST-Ⅱ)]在低温条件下保存离体鼠心的效果。方法54只雄性SD大鼠随机均分为HTK组、FWM组、ST-Ⅱ组(n=18),各组再根据低温保存时间分为4、6、8h3个亚组(n=6)。采用Langen-dorff装置进行心脏保存前后的灌注,各实验组分别使用不同保存液灌停心脏并在低温条件下保存4、6、8h,于灌停前及复灌后测定心率(HR)、冠脉流量(CF)、左心室收缩压(LVSP)、左心室内压最大上升速率(+dp/dtmax)、左心室内压最大下降速率(-dp/dtmax)等指标,并计算各指标的恢复率。灌注结束后,取心肌组织制作光镜标本,观察心肌组织结构变化。结果在相同的低温保存时间下,与ST-Ⅱ组相比,HTK组与FWM组心功能各指标恢复率明显较高,光镜下心肌组织结构变化较小。随保存时间延长,使用HTK液保存的鼠心心功能恢复率下降,组织结构发生改变,8h亚组与4、6h亚组间比较差异显著(P<0.05),而4h亚组与6h亚组间无显著差异(P>0.05)。结论在保存时间相同的条件下,HTK液及FWM液的心肌保存效果明显优于ST-Ⅱ液。HTK液保存效果随低温保存时间延长而逐渐降低,保存8h后明显下降。Objective To compare the results of three kinds of heart preservative fluids,namely histidine-tryptophan-ketoglutarate（HTK）solution,Fuwai modified solution（FWM）and St.Thomas＇ Hospital cardioplegic solution number 2（St.Thomas-Ⅱ）for the preservation of isolated rat hearts under low temperature.Methods Fifty-four male SD rats were randomly divided into HTK,FWM and ST-Ⅱ groups（18 each）,and each group was divided into three subgroups（6 each）according to different duration of preservation under low temperature（4,6 and 8 hours）.The hearts were harvested and then mounted on the Langendorff apparatus and perfused with K-H buffer solution for determination of the baseline hemodynamic values（HR,LVSP,±dp/dtmax and CF）.The isolated hearts were then arrested and stored in different preservative solution as mentioned at 4℃ for 4,6 or 8 hours.The hemodynamic values were measured before cardiac arrest and after cardiac reperfusion in Langendoff model,and the recovery rates of the values were calculated.The hearts were finally sectioned after reperfusion for the observation of morphological changes with light microscope.Results With the same hypothermic preservation time,the recovery rates of hemodynamic values were significantly higher,and the changes in myocardial structures were obviously less in HTK and FWM groups than in ST-Ⅱ group（P〈0.05）.In HTK group,the recovery rate of hemodynamic values decreased and the changes in myocardial structures became more obvious with prolongation of preservation time,and significant differences were observed between 8h subgroup and 4h,6h subgroups,but no significant difference between 4h subgroup and 6h subgroup was seen（P〉0.05）.Conclusions HTK and FWM solutions are more effective than St.Thomas-Ⅱsolution in preservation of isolated heart under low temperature with the same storage duration.The effect of HTK solution for preservation of isolated heart descended with the prolongation of preservation time,especially so after 8 hours.

关 键 词：器官保存液 低温保存 心肌保护 

分 类 号：R614.25[医药卫生—麻醉学]