不同处理方法心肌保护作用的比较研究  

A comparative study on preconditioning,postconditioning and pharmacological postconditioning on isolated rat hearts

作　　者：毛张凡[1] 徐小惠[2] 毛志福[1] 黄杰[1] 耿庆[1] 

机构地区：[1]武汉大学人民医院胸心外科,湖北武汉430060 [2]华中科技大学同济医院药剂科,湖北武汉430030

出　　处：《临床和实验医学杂志》2012年第22期1772-1773,1776,共3页Journal of Clinical and Experimental Medicine

摘　　要：目的研究常规预适应、后处理与药物后处理对大鼠离体心脏再灌注损伤保护作用的异同并探讨其机制。方法 SD大鼠共50只,随机分为5组:停灌/再灌组(I/R);预适应组(IPC);后处理组(POS);吗啡后处理组(MOR);预适应加后处理组(IPC+POS),行Langendorff心脏灌流。观测其血流动力学、心肌梗死面积、肌酸激酶(CK)、乳酸脱氢酶(LDH)以及超微结构变化。结果与I/R相比,4个实验组均能明显的改善心功能,减小心梗面积,减少心肌酶释放,减轻超微结构损伤。而MOR的心肌保护作用明显低于IPC、POS和IPC+POS。此三组的心肌保护效果差异有统计学意义(P<0.05)。结论预适应和后处理可能有大部分相同的心肌保护机制。而药物后处理只能激活部分机制而达到部分心肌保护作用。Objective The aim of this study is to explore the protective effect of ischemic preconditioning （ IPC ）, postconditioning （POS）, preconditioning plus postconditioning and pharmacological postconditioning on ischemiafrepeffusion （I/R） injury and to discuss its pro- tective mechanism on isolated hearts of rats. Methods Isolated hearts of 50 male SD rats were perfused with Langendorff perfusion method. Injury was induced by ischemia for 30rain and reperfusion for 60rain. After stabilization for 30 min, 50 hearts were randomly and equally divided into 5 groups： I/R group; IPC group; POS group; morphine （MOR） group and/PC ＋ POS group. Hemodynamic data, size of myocardial infarction, concentrations of LDH and CK were measured. Results All these four ways could considerably reduce the size of infarction, improve hemodynamic condition and decrease concentrations of LDH and CK （ P 〈0.05 ）. There was no remarkable difference among these results in IPC, POS, [PC ＋ POS groups. However the size of infarction in MOR group was obviously larger than that of other three groups. Conclusion Preconditioning and postconditioning may provide protective effect of myocardium by the same mechanism. The reason that morphine only can provide partial cardiopro- teetive effect may possibly be activation of partial mechanism of myocardial protection.

关 键 词：再灌注损伤 心肌保护 缺血预适应 缺血后处理 药物后处理 

分 类 号：R541[医药卫生—心血管疾病]