离体糖尿病大鼠心肌对缺血再灌注损伤的耐受性研究  

Tolerance of isolated myocardium on ischemia-reperfusion injury in diabetic rat

作　　者：王寿世[1] 宋婷婷[2] 黑飞龙[3] 陆惠元[1] 宁吉顺[1] 曹焕军[4] 兰克涛[5] 

机构地区：[1]山东省青岛市中心医院青岛大学医学院第二附属医院麻醉科,266042 [2]山东省青岛市中心医院青岛大学医学院第二附属医院肿瘤内科,266042 [3]中国医学科学院阜外心血管病医院体外循环科 [4]潍坊医学院麻醉学系 [5]山东省青岛市中心医院青岛大学医学院第二附属医院心内科,266042

出　　处：《中国医药》2013年第1期57-59,共3页China Medicine

摘　　要：目的探讨离体糖尿病大鼠心肌对缺血再灌注损伤的耐受性。方法将44只SD大鼠完全随机分为非糖尿病对照组、非糖尿病托马斯停搏液（STH-2）组和糖尿病对照组、糖尿病STH-2组，各11只，糖尿病对照组和糖尿病STH-2组均建立糖尿病大鼠模型。4组大鼠均使用离体心脏灌流装置测定心功能指数及冠状动脉肌钙蛋白漏出含量，并观察心肌组织超微结构改变。结果非糖尿病STH-2组心脏保存4h后左心室形成压（LVDP）及左心室内压变化最大速率（±dp／dtmax）均明显低于非糖尿病对照组[LVDP：（162±41）mmHg（1mmHg=0．133kPa）比（344±37）mmHg；dp／dtmax：（4340±156）mmHg／s比（10438±252）mmHg／s；-dp／dtmax：（2440±152）mmHg／s比（4942±78）mmHg／s]，差异均有统计学意义（均P〈0．05）；糖尿病STH-2组心脏保存4h后LVDP、±dp／dtmax亦有不同程度的下降[分别为（148±13）mmHg、（2586±34）mmHg/s、（2135±82）mmHg／s]，但与糖尿病对照组相比差异均无统计学意义（均P〉0．05）；糖尿病组LVDP、±dp／dtmax均低于对应的非糖尿病组（均P〈0．05）。非糖尿病STH-2组肌钙蛋白漏出含量明显高于非糖尿病对照组[（0．190±0．020）μg/L比（0．020±0．001）μg/L，P〈0．05]；糖尿病STH-2组肌钙蛋白漏出含量明显高于糖尿病对照组[（0．360±0．050）μg/L比（0．140±0．030）μg/L，P〈0．05]；非糖尿病STH-2组肌钙蛋白漏出量低于糖尿病STH-2组，差异有统计学意义（P〈0．01）。电镜观察显示，非糖尿病对照组心肌结构基本正常，而非糖尿病STH-2组变化明显。糖尿病组较非糖尿病组心肌结构变化明显，心肌纤维化、线粒体增生数量明显增多。结论糖尿病大鼠心肌对缺血再灌注损伤的耐受性优于非糖尿病大鼠。Objective To explore the tolerance of diabetic rat＇s isolated myocardium on ischemia- repeffusion injury. Methods All 44 male SD rats were randomly divided into non-diabetic control group, non- diabetic STH-2 （ St. Thomas Hospital 2） group, diabetic control group and diabetic STH-2 group （with 11 rats in each group）. Cardiac function index included left ventrieular developed pressure（LVDP） ; ±dp/dtmax was determined by Powerlab physiological functions recorder; troponin was measured and mycardiol ultramicrostructure was observed. Results Between non-diabetic control group and non-diabetic STH-2 group, LVDP and ±dp/dtmax had significant difference after hearts being preserved for 4 hours [ LVDP： （ 162 ± 41 ） mm Hg（ 1 mm Hg = 0. 133 kPa） vs （ 344 ±37 ）mm Hg ; dp/dtmax ： （4340 ± 156） mm Hg/s vs （ 10 438 ± 252） mm Hg/s ; - dp/dtmax ： （ 2440 ± 152 ） mm Hg/s vs （4942 ± 78）mm Hg/s] （all P 〈 0.05）. Compared with diabetic control group, LVDP and ± dp/dtmax also decreased after being preserved for 4 hours in diabetic STH-2 group [ （ 148 ± 13 ） mm Hg, （2586 ± 34） mm Hg/s, （2135 ±82）mm Hg/s, respectively], but there was no significant difference （all P 〉 0.05 ）. The diabetic groups had low cardiac function index compared with non-diabetic groups （ P 〈 0.05 ）. The troponin in non-diabetic STH-2 group and diabetic STH-2 group was higher than that in non-diabetic control group and diabetic control group [ （0. 190 ± 0. 020） μg/L vs （0. 020 ± 0. 001 ） μg/L, （0. 360 ± 0. 050 ） μg/L vs （0. 140 ±0. 030） μg/L, all P 〈 0. 05 ] ; the troponin in diabetic STH-2 group was higher than that in non-diabetic STH-2 group, and the difference was significant （ P 〈 0. 01 ）. In non-diabetic groups, electron microscope result showed that control group had normal ultramicrostrueture. Diabetic groups had worse ultramicrostructure compared with non-diabetic groups. Heart muscle fibrosis and mitochondria hyperplasia were the main f

关 键 词：心肌保护 心肌停搏液 离体心脏灌流模型 糖尿病 

分 类 号：R541[医药卫生—心血管疾病]