红细胞停跳液的心肌保护作用及对心肌微血管通透性的影响  

Effects of erythrocyte cardioplegia on myocardial protection and microvessel permeability

作　　者：王胜洵[1] 陈生龙[2] 高岚[3] 王京生[2] 漆一伟[2] 解基严[2] 

机构地区：[1]北京安贞医院心外科,100029 [2]北京大学人民医院心外科 [3]北京大学人民医院麻醉科

出　　处：《中华实验外科杂志》2001年第5期399-401,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目 (39770 72 8)

摘　　要：目的　制作一种新的停跳液———红细胞停跳液 (EC) ,并观察它的心肌保护作用以及同全血停跳液 (BC)和去白细胞停跳液 (DC)的差异。方法　用滤器去除大鼠 ( 2 4只 )血液中的白细胞和血小板 ,配制红细胞停跳液 ,并应用Langendorff离体心模型 ,测定心率 (HR)、左心室收缩压(LVSP)、左心室舒张末压 (LVEDP)、心肌最大收缩速度 (Dp/Dtmax)、冠状动脉流量 (CF) ;灌流流出液中的肌酸激酶 (CK)、乳酸、葡萄糖含量以及心肌组织内的伊文思蓝 (EB)的含量和湿干比值。结果　红细胞停跳液组HR、LVSP的恢复率 [BC ( 6 4.0± 14 .1) %、DC ( 5 5 .4± 11.9) %、EC( 75 .3±14 .2 ) % ] ;CF的恢复率 [BC( 6 2 .49± 14 .6 9) % ,DC( 6 6 .6 3± 7.5 4) % ,EC( 79.15± 12 .18) % ]、乳酸、葡萄糖、伊文思蓝的含量 [EC( 80 .11± 2 1.13) μg/g ,DC( 12 9.80± 39.4) μg/g ,BC( 186 .0 3± 11.89)μg/g]和湿干比值 (BC :5 .91± 1.30 ,DC :4.96± 0 .2 4,EC :4.5 8± 0 .36 )与对照组间比较差异有显著性 (P <0 .0 5 )。Objective To make a new cardioplegia: erythrocyte cardioplegia(EC) and to investigate the effects of EC on myocardial protection and to compare the difference of EC, blood cardioplegia(BC), and leukocyte depleted cardioplegia(DC).Methods A blood filter was applied to deplete leukocytes and platelets to make a new cardioplegia: erythrocyte blood cardioplegia. Isolated rat hearts undergoing arrest followed by 1?h of global ischemia and 60 min of reperfusion were studied using the modified Langendorff model.HR,LVSP,LVEDP,Dp/Dtmax,CF,CK,lactate,glucose,EB content in myocardium and wet to dry ratio were measured.Results The differences among the three groups (EC, BC, DC, n=8), in dynamics [recovery ratio of HR and LVSP (64.0±14.1)% in BC,(55.4± 11.9)% in DC, (75.3±14.2)% in EC; CF recovery ratio (62.49±14.69)% in BC, (66.63± 7.54)% in DC, ( 79.15 ±12.18)% in EC respectively],the lactate and glucose levels of effluent,EB content in BC (186.03± 11.89)?μg/g,in DC(129.80±39.40)μg/g,in EC(80.11±21.13)?μg/g respectively and the wet to dry ratio (5.91±1.30 in BC,4.96±0.24 in DC,4.58±0.36 in EC) were statistically significant, There was significant difference between the experimental groups and control groups (P <0.05). Conclusion EC may have better myocardial protective effects than BC or DC.

关 键 词：心麻痹液 局部缺血 再灌注损伤 心肌保护 红细胞停跳液 心肌微血管通透性 

分 类 号：R654.2[医药卫生—外科学]