家犬无搏动供体心脏耐受热缺血时限的研究  

The warm ischemia time limit of non-heart-beating donors heart for transplantation in Canis familiaris

作　　者：章庆春[1] 尹海辉[1] 严中亚[1] 吴岳恒[2] 肖学钧[2] 

机构地区：[1]安徽省立医院心脏外科,合肥230001 [2]广东省心血管病研究所

出　　处：《中华实验外科杂志》2011年第8期1218-1221,共4页Chinese Journal of Experimental Surgery

摘　　要：目的观察无博动供体（NHBDs）心脏可耐受热缺血的时限。方法通过窒息法和放血法获得不同热缺血时间的家犬NHBDs心脏，以无热缺血心脏为对照组，其他各时间段为实验组，NHBDs心脏在4℃HTK液中保存2h后进行原位心脏移植，供心复跳后继续辅助循环60min后撤机。监测再灌注3h后的血流动力学参数，测定再灌注3h后心脏组织含水量和超微结构改变。结果窒息法获得的家犬NHBDs心脏能耐受的热缺血时间为16min，热缺血17min为其功能转折点；放血法获得的家犬NHBDs心脏能耐受的热缺血时间为27min，热缺血28min为其功能转折点。在热缺血安全时限点获得的NHBDs心脏用于移植后，窒息法NHBDs心脏的左室舒张功能（-dp／dtmax）要低于放血法NHBDs心脏（1361．68±231．47比1641．68±192．47，P〈0．05），但两者在左室收缩功能上差异无统计学意义（P〉0．05）。结论窒息法和放血法获得的家犬NHBDs心脏在耐受热缺血时都存在功能转折点，两者之间相差有11min。在热缺血安全时限内保存2h的犬NHBDs心脏均成功用于移植，这为NHBDs心脏的初步活性判断提供实验依据。Objective To study the warm ischemia time limit of non-heart-beating donors （NH- BDs） heart for transplantation. Methods The NHBDs heart endured different warm ischemia time limit by asphyxiation or depletion method in Canis familiaris （15 ± 3） kg, being harvested and preserved in 4 ℃ HTK solution for transplantation. The NHBDs heart endured 0 min warm ischemia time as control. All NHBDs hearts were preserved for 2 h and transplanted to weight-matched recipients. The assist circulation was removed when the donor heart re-beat for 60 min, and the hemodynamic parameters were monitored at 3 h after reperfusion. Meanwhile, cardiac ultramicrostructure was also examined at 3 h after reperfusion. Resuits The warm ischemia time limit was 16 min in NHBDs heart induced by asphyxiation, and 27 min in NHBDs heart induced by depletion method in Canis Familiaris. The diastolic function of left ventricle （ - dp/dtmax） was decreased significantly in asphyxiation NHBDs heart （ 1361.68 ± 231.47 vs 1641.68 ± 192. 47 ,P 〈 0. 05 ）, but there was no significant difference in contractile function between asphyxiation or depletion methods （P 〉 0. 05 ）. Conclusion The NHBDs heart harvested by asphyxiation or depletion method in Canis Familiaris all had a warm ischemia time limit and break point of function.

关 键 词：无博动供体 心脏移植 热缺血时间 家犬 

分 类 号：R654.2[医药卫生—外科学]