不同灌注保存方法对猪离体供心保护作用的比较  

Comparative study of different perfusion for protecting heart graft in pigs

作　　者：胡志斌[1] 严志焜[1] 王海涛[1] 潘晓华[1] 

机构地区：[1]浙江省人民医院浙江省器官移植重点实验室(心脏分室),杭州310014

出　　处：《中华移植杂志（电子版）》2013年第3期17-20,共4页Chinese Journal of Transplantation(Electronic Edition)

基　　金：浙江省自然科学基金(LY12H02007)

摘　　要：目的比较不同灌注保存方式对离体猪心的保护作用。方法以36只健康雄性巴拿马小香猪为实验对象,取出供心后根据保存技术不同分为不保存组、单纯浸泡组和以50 mL灌注容量为基础并递增,间隔时间为2 h的50,100,150 mL,200 mL间断灌注组,每组各6例。心脏灌注液和保存液均为二氮嗪强化的Celsior液(含二氮嗪30μmol/L),保存温度为4℃,保存时间10 h。比较各组左心室心肌细胞凋亡指数(AI)、心肌组织ATP含量(ATPC)、心肌含水量(MWC)和电镜心肌超微结构。结果心脏保存后,与不保存组比较,心肌细胞发生较多凋亡、心肌组织ATP C明显降低以及出现不同程度的心肌水肿损伤等。单纯浸泡组AI最高(34.80±0.14)%,ATP C水平最低(1.85±0.09)nmol/mg,MWC最高(82.03±0.11)%。200 mL间断灌注组AI最低(12.35±0.10)%,ATP C水平最高(2.32±0.03)nmol/mg,MWC最低(77.12±0.85)%;电镜心肌超微结构显示,不保存组的心肌结构最为正常,其次为150,200 mL间断灌注组。结论在长时间心脏保存中,间断灌注保存技术对心肌的保护作用优于单纯低温浸泡保存技术;间隔2 h灌注1次,每次灌注容量为200 mL的间断灌注保存技术对心肌的保护效果较好。Objective To compare the protective effects of different perfusion in isolated hearts of pigs.Methods The Bama miniature pigs＇ donor hearts were arrested with Celsior cardioplegia solution enhanced with diazoxide（ DE,30 μmol / L）.Isolated hearts were not preservation in un-stored group and stored in the solution in stactic cold storage group or placed in a device that providing intermittent perfusion with 50,100,150,200 mL solution respectively every 2 hours in intermittent perfusion group for 10 hours at 4 ℃（ n=6 per group）.After storage,left ventricle samples were frozen,extracted,then the apoptotic index of cardiomyocytes（ AI）,adenosine triphosphate concentrations（ ATP C）,myocardial water content（ MWC） and myocardial ultrastructure were analyzed.Results After long-time hypothermic storage,compared with un-stored group,there were significantly higher with AI,MWC and lower with ATP C in the stactic cold storage group and intermittent perfusion group.The stactic cold storage group shown the highest AI [（ 34.80±0.14） %]and MWC [（ 82.03±0.11） % ],but lowest ATP C level [（ 1.85±0.09） ].The 200 mL intermittent perfusion group shown the lowest AI[（ 12.35±0.10） % ]and MWC[（ 77.12±0.85） % ],but the highest ATP C level [（ 2.32±0.03） nmol / mg].The myocardial histological results were best in unstored group and better in the intermittent perfusion which were infusion 150 or 200 mL cardioplegia solution every 2 hours.Conclusions The intermittent perfusion provide better myocardial protection than cold static storage in isolated heart preservation for 10 hours at 4 ℃.Perfusing with 200 mL solution every 2 hours shown a more superior protective effect.

关 键 词：Clesior液 间断灌注 猪 心脏 二氮嗪 

分 类 号：R654.2[医药卫生—外科学]