体外循环中心肌磷脂酶A_2的变化及其对心肌细胞膜磷脂的影响  

THE CHANGES IN PLA_2 IN CARDIOMYOCYTES AND ITS EFFECTS ON PHOSPHOLIPIDS OF MYOCARDIAL CELL MEMBRANE DURING CARDIOPULMONARY BYPASS

作　　者：丁芳宝[1] 梅举[1] 王志农[1] 陈晓东[2] 张宝仁[1] 

机构地区：[1]第二军医大学长海医院,上海200433 [2]广州军区广州总医院

出　　处：《解放军医学杂志》2001年第12期890-892,共3页Medical Journal of Chinese People's Liberation Army

基　　金：国家自然科学基金资助课题 (编号 3950 0 1 4 7)

摘　　要：在动物模型上观察体外循环 (CPB)缺血再灌注过程中心肌细胞磷脂酶A2 (PLA2 )的变化规律及其对细胞膜磷脂组份的影响 ,并评价两种心肌保护方法对心肌细胞膜的保护效果。结果发现 ,心肌细胞膜总磷脂、卵磷脂、脑磷脂出现降解前先有PLA2 的激活 ;主动脉阻断 6 0min期间 ,各心肌保护组PLA2 活性、总磷脂、卵磷脂和脑磷脂含量无明显变化 ;再灌注早期 ,PLA2 活性迅速升高 ,总磷脂、卵磷脂和脑磷脂含量则迅速减少 ,均于再灌注 30～ 6 0min后出现程度不一的恢复 ;CPB期间 ,常温体外循环温血停搏液持续灌注组PLA2 活性、总磷脂、卵磷脂和脑磷脂含量变化幅度较小。提示CPB中心肌细胞膜的损伤可能是PLA2 激活的结果 ,常温体外循环温血停搏液持续灌注对心肌细胞膜的保护效果较佳 ,但仍需进一步改进。To study the ischemia/reperfusion-induced dynamic changes in PLA 2 in cardiomyocytes and its effect on phospholipids of cardiomyocyte membrane during cardiopulmonary bypass (CPB), and to evaluate the protective effects of two kinds of cardioplegia. The results showed that there was an increase in PLA 2 activity during CPB followed by decreases in the contents of total phospholipids, phosphatidylcholine and phosphatidylethanolamine. During the 6o-min aorta occlusion beriod,there were no obvious changes in the activity of PLA 2 and the contents of total phospholipids, phosphatidylethanolamine and phosphatidylcholine when cardioplegia was used. During early reperfusion, there were a rapid increase in PLA 2 activity accompanied by a rapid decrease in contents of phospholipids.However,after 30~60min reperfusion, the contents of phospholipids for group C, D began to increase and the PLA 2 activity began to decrease. The changes in the contents of phospholipids and the PLA 2 activity in extracorporeal circulation with warm blood cardioplegia group were smaller in magnitude. These results suggested that the myocardial membrane injury was dependent on PLA 2 activation. Warm blood cardioplegia could provide better myocardial protection, and warrant further improvements.

关 键 词：体外循环 心肌再灌注损伤 磷脂酶A类 

分 类 号：R654.1[医药卫生—外科学]