体外循环下低pH液复灌对兔心肌缺血再灌注损伤的影响  

Effect of acidic reperfusion on myocardial ischemia/reperfusion injury by cardiopulmonary bypass in rabbits

作　　者：杨海燕[1] 刘新伟[1] 王群英[1] 马亚飞[1] 刘柳[1] 

机构地区：[1]重庆医科大学附属第一医院麻醉科,重庆400016

出　　处：《重庆医科大学学报》2011年第1期16-19,共4页Journal of Chongqing Medical University

基　　金：重庆市卫生局自然科学基金资助项目(编号:2009-2-344)

摘　　要：目的:探讨体外循环(Cardiopu lmonary bypass,CPB)下再灌注初短暂低pH液复灌对兔心肌缺血再灌注损伤的保护作用并确定灌注液的最佳pH值。方法:选择健康成年新西兰大白兔30只,雌雄不拘,体重2.5～3.0 kg,随机分为5组(n=6),对照组不阻断主动脉,单纯转机180 min;其余各组心脏停搏缺血40 min,再灌注120 min,再灌注前2 min分别给予pH值为7.4、7.1、6.9、6.7的Krebs-Henseleit液(K-H液)持续灌注至主动脉开放。实验结束后,比色法测定心肌组织中乳酸脱氢酶(Lactate dehyd rogenase,LDH)活力及ELISA测定肌钙蛋白I(Cardiac troponin I,cTnI)浓度;光镜观察心肌组织形态学改变;透射电镜下观察心肌组织超微结构。结果:与对照组比较,各组LDH c、TnI均增加(P<0.05),与pH7.4组比较,低pH液复灌各组LDHc、TnI均降低(P<0.05),其中pH6.9组LDHc、TnI最低;病理学检查示pH7.4组损伤最严重,低pH液复灌各组中pH6.9组损伤最轻。结论:体外循环下再灌注初短暂低pH液复灌产生心肌保护作用,且pH6.9的K-H液灌注产生的效果最好。Objective：To determine the effect of acidic reperfusion on myocardial ischemia/reperfusion injury by cardiopulmonary bypass（CPB） and choose the optimum pH of perfusion fluid.Methods：thirty adult New Zealand white rabbits of both sexes weighing 2.5～3.0 kg were randomly divided into 5 groups（n=6 each）.In control group,CPB was executed for 180 min without aortic clamping.In the other groups,hearts were subjected to ischemia for 40 min followed by 120 min of reperfusion,and were respectively perfused with Krebs-Henseleit bicarbonate buffer solution at pH 7.4,7.1,6.9 and 6.7 in the first 2 min of referfusion.After 2 h reperfusion,the lactate dehydrogenase（LDH） activity was tested with colorimetric method,cardiac troponin I（cTnI） concentration was determined with ELISA and myocardial tissues were observed by light microscopy and transmission electron microscope.Results：In the other groups,the LDH activity and cTnI concentration were significantly increased as compared with in the control group（P0.05）.Compared with pH 7.4 group,the LDH activity and cTnI concentration were significantly lower in acidic reperfusion groups（P0.05）,and were lowest in pH 6.9 group.The pH 7.4 group showed the most serious injury while the pH 6.9 group showed the least damage in the acidic reperfusion groups by pathological examination.Conclusion：Acidic reperfusion can attenuate the myocardial ischemia/reperfusion injury by CPB in rabbits and the reperfusion of Krebs-Henseleit bicarbonate buffer solution of pH 6.9 provides best protective effect.

关 键 词：心肺转流术 氢离子浓度 再灌注损伤 

分 类 号：R614[医药卫生—麻醉学] R654.1[医药卫生—外科学]