乳酸和饱和氢盐水联合药物后适应减轻大鼠心肌再灌注损伤的研究  

Pharmacological postconditioning with lactic acid and hydrogen saline could attenuate myocardial reperfusion injury in rats

作　　者：张国明[1] 沈虹[1] 孙媛媛[2] 刘丽凤[3] 王禹[3] 李晓燕[1] 许琳[1] 谈红[1] 陈瑞敏[1] 

机构地区：[1]济南军区总医院心内科,250031 [2]济南军区总医院超声科,250031 [3]解放军总医院老年心血管病研究所

出　　处：《中华临床医师杂志（电子版）》2013年第16期76-79,共4页Chinese Journal of Clinicians(Electronic Edition)

基　　金：国家自然科学基金(30740080);济南军区总医院院长青年基金(2011Q08)

摘　　要：目的探讨乳酸和氢饱和盐水能否减轻心肌细胞损伤。方法 72只SD大鼠随机分为假手术、缺血再灌注(R/I)、机械后适应(Post,再灌注/缺血时间为20/20 s×4)、乳酸(Lac,微量注射器心肌注射乳酸)、氢饱和盐水(Hyd,微量注射器心肌注射低剂量氢饱和盐水)和乳酸+氢饱和盐水组(Lac+Hyd,微量注射器心肌注射乳酸和低剂量氢饱和盐水)6组。测定再灌注3 min后右心房血浆pH值,处死大鼠取心肌组织测定MDA和SOD含量;另测定24 h后血流动力学、动脉血心肌酶含量和心肌梗死面积。结果 Lac+Hyd组再灌注后3 min右心房血浆pH值显著低于R/I组(7.32±0.06 vs.7.43±0.03,P<0.05),MDA含量显著低于R/I组[(1.14±0.16)nmol/mg pro vs.(1.56±0.21)nmol/mg pro,P<0.05],SOD含量高于R/I组[(57.92±15.12)U/mg pro vs.(35.48±12.46)U/mg pro,P<0.05]。再灌注24 h后,Lac+Hyd组CK[(579.00±223.61)U/L vs.(1268.52±211.53)U/L,P<0.05]和CK-MB[(392.94±166.25)U/L vs.(962.21±273.80)U/L,P<0.05]含量显著低于R/I组,心肌梗死面积比例显著低于R/I组(27.01%±6.56%vs.49.18%±8.52%,P<0.05)。以上指标均与Post组相比均无明显差异(P均>0.05)。Lac组和Hyd组CK和CK-MB含量显著低于R/I组,显著高于Post组Lac+Hyd组(P均<0.05),但心肌梗死面积比例同R/I组比较无统计学差异(P>0.05)。结论局部注射乳酸和氢饱和盐水可较好模拟机械后适应,有效减轻心肌细胞损伤。Objective To test that pharmacological postconditioning with lactic acid and hydrogon saline could mimic the mechanical postcamditioning and attenuate myocardial reperfusion injury. Methods 72 SD rats were randomly divided into 6 groups： sham, rcperfusion/injury（R/I）, postconditioning （Post）, lactic acid （Lac）, Hydrogen saline （Hyd）, and lactic acid＋Hydrogen saline （Lac＋Hyd） group. After 3 min of reprfusion, pH value of right atrial plasma was detected. Then the rats were executed to measure the contents of myocardial MDA and SOD. After 24 hours of reperfusion, values of hemodynamics and the contents of myocardial enzyme in arterial blood were measured and the ratio of infarct area was deter＇ted. Results After 3 rain of reperfusion, pH of blood from right atrium in Lac±Hyd group was significantly lower than that in R/I group （7.32±0.06 vs. 7.43 ±0.03, P〈0.05）, the contents of MDA was lower[ （ 1.14±0.16） nmol/mg pro vs. （ 1.56±0.21 ） nmol/mg pro, P〈0.05] and the content of SOD was higher[ （57.92± 15.12） U/mg pro vs. （35.48± 12.46） U/mg pro, P〈0.05] than that in R/I group. Afler24hoursofreperfusion, the contents of CK[ （579.00±223.61） U/Lvs. （1268.52±211.53） U/L, P〈0.05] and CK-MB[ （392.94± 166.25） U/L vs. （962.21±273.80） U/L, P〈0.05] in Lac＋Hyd group were all significantly lower than R/I group, furthermore, the ratio of infarct area in Lac＋Hyd group was significantly lower than that in RⅡ group（27.01%±6.56% vs. 49.18%±8.52%, P〈0.05）. At the same time, all above varibles in Lac＋Hyd group were similar to those in Post group（P〉0.05）. The level of CK and CK-MB in Lac and Hyd group were all significantly lower than those in R/I group, higher than those in Post and Lac＋Hydgroup（P〈0.05）. However, the ratio of infarct area in Lac and Hyd group were similar to that in R/I group （P〉0.05）. Conclusion Pharmacological postconditioning with lactic acid and hydrogen saline could mimic the mechanism of mechanic

关 键 词：心肌再灌注损伤 后适应 酸中毒 乳酸 氢气 

分 类 号：R965[医药卫生—药理学]