乌司他丁对体外循环下犬心肌ICAM-1表达的影响  

Effects of ulinastatin on the expression of intercellular adhesion molecule-l in canine myocardial injury during cardiopulmonary bypass

作　　者：阳世雄[1] 刘庆远[1] 曾建业[1] 韦涌初[1] 黄思光[1] 卢苇[1] 潘小明[1] 

机构地区：[1]广西医科大学第三附属医院心胸外科,南宁530031

出　　处：《中国临床新医学》2011年第5期407-410,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

基　　金：广西科技开发项目(编号:桂科攻0015034)

摘　　要：目的研究乌司他丁应用于体外循环(CPB)中对犬心肌组织中细胞间黏附分子-1(ICAM-1)表达的影响及其对心肌的保护作用。方法试验用杂种犬20只,随机平均分为乌司他丁实验组(U组)和对照组(C组),每组各10只。U组在CPB预充液中加1万U/kg乌司他丁,并于CPB转机开始前即经静脉再给1万U/kg乌司他丁持续滴注。C组常规建立CPB并转机。分别于CPB转机前10min(A时点)和CPB转机后60 min(B时点)两个时点,切取犬心肌右心耳组织,检测心肌组织ICAM-1表达量;记录CPB建立时间、主动脉阻断时间、主动脉灌注时间、CPB转机时间、心脏复跳情况。结果两组实验犬心肌组织中,ICAM-1的表达量在B时点较A时点均明显增高,但在B时点U组ICAM-1表达量低于C组(P<0.05)。结论 CPB时,心肌组织的缺血-再灌注损伤可引起心肌组织ICAM-1表达上调,乌司他丁可减轻心肌的炎症反应,进而保护心肌组织。Objective To investigate the effect of ulinastatin on the expression of intercellular adhesion molecule -1 (ICAM-1) in canine myocardium during the CPB, evaluate whether ulinastatin could influence the expression of ICAM-1 and its protective effect on myocardium. Methods Twenty dogs were randomly divided into two groups: ulinastatin group and control group. In ulinastatin group (n = 10) dogs received ulinastatin 20 000 unit ? kg^(-1), half was added into the CPB priming fluid, and another half was given by intravenous injection before CPB running. In control group (n = 10) dogs received CPB conventionally, the same volume of saline instead of (?)inastatin. Right atrial appendage of the dog was obtained at 10 minutes before CPB running (point A) and at 60 minutes after CPB running (point B). The expression of ICAM-1 in cardiac myocytes was measured. And the establishment and running time of CPB, arotic cross -clamp time, aortic perfusion time and heart re-beat were recorded. Results The expression of ICAM-1 in myocardial tissue after CPB in both groups increased and it was higher in control group than that in ulinastatin group (P < 0. 05). Conclusion Myocardial ischemical reperfusion injury can cause the up-regulation of expression of ICAM-1 in myocardium, ulinastatin can restrain the expression of the ICAM-1, thus protecting the myocardial tissue by inhibiting the myocardial inflammation.

关 键 词：乌司他丁 体外循环 心肌保护 细胞间黏附分子-1 

分 类 号：R654.1[医药卫生—外科学]