离体猪心冠状动脉内皮在机械胸外按压心肺复苏术后不同保存方法下的改变  

Effects of different preservation methods on isolated pig heart coronary endothelial after mechanical chest compressions cardiorespiratory resuscitation

作　　者：张国瑜[1] 张双林[1] 董彦军[1] 郑先杰[1] 李帅[1] 廖秋明[2] 

机构地区：[1]河南大学第一附属医院胸心血管外科,开封475003 [2]瑞典隆德大学医学院心胸外科

出　　处：《中华实验外科杂志》2013年第4期756-758,共3页Chinese Journal of Experimental Surgery

摘　　要：目的观察经机械胸外按压心肺复苏术（MCPR）后，猪离体心脏分别在按压及低温间断灌注保存24h后，冠状动脉内皮细胞功能改变。方法健康瑞典家猪24头，随机分为对照组、按压组、间断灌注保存组3组，每组8头。对照组直接取心脏冠状动脉左前降支远端血管环行器官浴槽实验;后两组均先行人工诱导室颤，用自动心脏按压器（Lucas）行MCPR，20 min后电击除颤，心脏血流稳定且恢复至除颤前水平后，按压组切取心脏冠状动脉左前降支远端血管环立即进行器官浴槽实验;间断灌注组切取心脏后在保存容器中进行低温间断灌注保存24 h,再切取心脏冠状动脉左前降支远端血管环进行器官浴槽实验。评价3组冠状动脉内皮依赖性舒张（EDR）的变化。结果3 组最大内皮依赖性舒张（EDR_）分别为（98. 37 ±1.51）%、（95.50 ±1.07）%、（53. 25 ± 10. 98）%（F = 19. 35，0〈0.01）;50%最大舒张时？物质的浓度对数（pEC50）分别为6. 50 ±0. 33,6. 40 ±0. 23、5.79±0. 33（F = 5. 05,P〈0. 05）.与对照组及按压组比较，间断灌注组EDRmax与PEC5。均降低（P 〈0.05）,前两组间的EDRmax与pEC50差异无统计学意义（p〉0.05）。结论用Lucas行MCPR后短时间内对离体心脏冠状动脉内皮功能损伤不明显，间断灌注保存组心脏冠状动脉内皮功能有损伤，提示按压后长时间的保存对离体冠状动脉内皮功能的影响较大。Objective To study the function change of pig heart coronary artery endothelial cells after the rescue of mechanical chest compressions cardiorespiratory resuscitation （MCPR） , the isolated heart press and low-temperature intermittent infusion for 24 hours. Methods 24 healthy Swedish domestic pigs were randomly divided into3 group which including control group, pressing group, intermittent perfu- sion preservation group （ n = 8, every group）. Control group were directly taken heart left anterior descend- ing artery distal vascular ring organ baths experiment. The other two groups were first artificially induced ventricular fibrillation, then MCPR were taken with automatic cardiac massage （Lueas） , defibrillate after 20 minutes to make cardiac blood flow stably and restore to status of before defibrillation. The pressing group were taken organ baths experiment after cut heart left anterior descending artery distal vascular ring immediately. The intermittent perfusion group were taken organ baths experiment after the hearts were in- termittent perfusion for 24 hours in container and cut the heart left anterior descending coronary the distal vascular ring. At last, coronary artery endothelium dependent relaxation （EDR） changes were evaluated. Results The maximum endothefium-dependent relaxation （ EDRmax ） were （98.37 ± 1.51 ） %, （95.50 ± 1.07） % , （53.25 ±10. 98 ） % （ F = 19. 35, P 〈 0. 01 ） ; The concentration logarithmic of P substance when 50% maximal relaxation （ pEC50 ） were （6. 50 ±0. 33 ） , （6.40± 0. 23 ） , （5.79 ± 0. 33 ） （ F = 5.05, P 〈 0. 05 ）. Compared with the control group and the press group, the EDRmax and pEC50 of intermit- tent perfusion group both were lower （ P 〈 0. 05 ） , no significant difference between the two groups foward （P 〉 0.05 ）. Conclusion There is no obvious hurt on the isolated heart coronary endothelial dysfunction shortly after MCPR with Lueas. The long time store of isolated heart might heavily affect th

关 键 词：猪 冠状动脉 内皮 机械胸外按压心肺复苏术 间断灌注 低温 

分 类 号：R459.7[医药卫生—急诊医学]