离体兔心缺血后行低温灌注对心功能恢复的影响  

The effect of postischemic hypothermic perfusion on functional recovery of isolated rabbit heart

作　　者：田步升[1] 李国荣 王敬弘[1] 李正[1] 牛志高[1] 张伟[1] 

机构地区：[1]山西省长治医学院附属和平医院胸心外科,046000

出　　处：《中华胸心血管外科杂志》2000年第2期93-95,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的　研究离体兔心缺血后行低温灌注对心功能恢复的影响。方法　建立离体工作心脏灌注装置 ,16只雌性新西兰大白兔 ,随机分为常温组和低温组 (每组 8只 )。获取离体兔心后首先用Krebs Henseleit碳酸氢钠缓冲液 (37℃ ) ,逆行灌注 15min。以 12 5mmHg的左房充盈压及 73 5mmHg的流出压力对工作心脏灌注 2 0min后 ,分别测量主动脉流量、冠脉流量 ,继之施行 2 0min常温 (37℃ )缺血。随后进行 6 0min的低温 (低温组 )及常温 (常温组 )逆行灌注。再在 37℃下重建工作心脏模型 ,于 2 0min后记录恢复后的心功能。结果　主动脉流量、冠脉流量、心输出量两组缺血前的基础功能值无显著差异。比较缺血后心功能恢复程度 ,也未见两组间有统计学差异。结论　心肌缺血后低温灌注对心肌的缺血再灌注损伤无加重作用 ,体外循环心脏直视手术后的低温灌注期对心功能恢复无不良影响。Objective Hypothermia has been employed by the most of cardiovascular surgeons during open heat operations to enhance tolerance to ischemia. However, Considerable reports implicated hypothermia in an impairment of the postischemic recovery of heart function. We evaluated the effect of hypothermia during postischemia perfusion on functional recovery in isolated hearts. Method Sixteen female New Zealand rabbits were used and randomly divided into the normothermia and hypothermia groups (n=8 for each group). The isolated hearts harvested from the rabbits were initially perfused by Langendorff technique for 15 minutes with Krebs Henseleit bicarbonate buffer (37℃). Working heart technique was adopted for 20 minutes with a left atrial filling pressure of 12.5 mmHg and an outflow pressure of 73.5 mmHg. Baseline functional measurement, aortic flow, coronary flow and heart rate were recorded by timed collection of the coronary effluent and cardiac output, as calculated from the sum of the aortic and coronary flow rates. A period of 20 minutes global ischemia was then imposed and was followed by hypothermic (hypothermia group) or normothermic (normothermia group) perfusion for 60 minutes. Then the working heart mode was re established at 37℃ in both groups and functional recovery was recorded again at the end of a 20 minutes period. Results There was no statistical difference between the two groups for baseline functional measurement. No significant statistical difference was found between two groups for postischemia functional recovery. Conclusion Postischemic hypothermic perfusion as long as 60 minutes has no adverse effect on recovery of myocardial function after normothermic global ischemia.

关 键 词：心肌缺血 再灌注损伤 低温灌注 离体兔 

分 类 号：R654.1[医药卫生—外科学]