供心热缺血期间ATP和超微结构的变化  

The Changes of ATP and Ultrastructure of Donor Heart During Heat-Ischemia

作　　者：钟佛添[1] 巫国勇[1] 刘初生[1] 张希[1] 王治平[1] 

机构地区：[1]中山医科大学附属第一医院心胸外科,广东广州510080

出　　处：《中山医科大学学报》2001年第4期248-250,共3页Academic Journal of Sun Yat-sen University of Medical Sciences

基　　金：广东省医学科学技术研究基金资助项目 (A199712 3 )

摘　　要：【目的】探讨供心不同热缺血期间ATP下降程度和超微结构改变 ,以确定供心的热缺血时限。【方法】新西兰大白兔 2 4只 ,分成 4组 ,每组 6只 ,按常规取心方法分别在阻断主动脉后 0min ,5min ,10min ,15min取左室心肌组织测ATP值 ,用电镜观察心肌超微结构 ,比较二者的相关性。【结果】 4组心肌ATP含量分别为 (5 72± 0 31) ,(4 2 9± 0 19) ,(3 47± 0 39) ,(2 6 0± 0 42 ) μmol/g ,P <0 0 1,各时期的心肌超微结构亦有明显差别。ATP下降与超微结构改变呈平行关系 ,热缺血 10～ 15minATP下降至缺血前 5 0 % ,超微结构出现不可逆改变。【结论】ATP值是衡量供心质量的重要指标 ,其下降与心肌超微结构改变呈平行关系 ,热缺血 10min以上的供心不宜用于移植。Objective To investigate the relationship between ATP decrease and ultrastructure change of donor heart with different heat-ischemia time, in order to confirm the heat-ischemia time limit of the donor heart. Methods New-Zealand rabbits (n=24) were randomly divided into four groups. Left ventricular myocardial tissues were obtained 0 min, 5 min, 10 min, 15 min respectively after aorta clamp. ATP values were determined and the ultrastructure was observed. The correlation between the two was studied. Results ATP mean values were (5.72±0.31),(4.29±0.19),(3.47±0.39),(2.60±0.42) μmol/g respectively in 4 different groups (P<0.01), myocardial ultrastructure also presented with obvious difference in different groups. ATP decrease was parallel to the change of myocardial ultrastructure. ATP value decreased by 50% 10～15 min after heat-ischemia. Ultrastructure also presented with irreversible change. Conclusion ATP value is an important index to evaluate the donor heart quality. The decrease of ATP value was parallel to the change of myocardial ultrastructure. The donor heart is unsuitable for transplantation when heat-ischemia time is over 10 min.

关 键 词：心脏移植 病理学 三磷酸腺苷 供心热缺血 ATP 超微结构 

分 类 号：R654.2[医药卫生—外科学]