缺血预处理联合St.ThomasⅡ心麻痹液对兔未成熟心脏功能和病理学影响  

Effect of ischemic preconditioning plus cardioplegic solutions on immature rabbit heart function and morphology

作　　者：朱斌[1] 闵苏[1] 龙村 

机构地区：[1]重庆医科大学临床学院麻醉科,重庆400016 [2]中国医学科学院阜外医院麻醉体外循环研究室,北京100037

出　　处：《重庆医科大学学报》2001年第4期407-409,415,共4页Journal of Chongqing Medical University

摘　　要：目的：研究缺血预处理（ＩＰＣ）对兔未成熟心肌缺血再灌注损伤的影响，并探讨其可能机制。方法：利用Ｌａｎｇｅｎｄｏｒｆｆ模型灌注幼兔（１４—２１天）离体心脏。１８只幼兔心随机分为２组，每组９只ＩＰＣ组经历５ｍｉｎ缺血、１０ｍｉｎ再灌的ＩＰＣ处理后，使用 Ｓｔ． ＴｈｏｍａｓⅡ心麻痹液（ＳＴＨ）使心脏停跳；对照组只用 ＳＴＨ停跳心脏。两组兔心均在生理体温（３９℃）下接受 ４５ｍｉｎ缺血、４０ｍｉｎ灌注。观察复灌后的心肌酶释放、心肌能量、心脏功能及病理学变化。结果：与对照组相比，ＩＰＣ组肌酸磷酸激酶同工酶（ＣＫ－ＭＢ）漏出量明显减少（Ｐ＜０ ．０１），心肌 ＡＴＰ含量以保存（Ｐ＜０． ０５），再灌注末心脏左室发展压（ＬＶＤＰ）显著改善（Ｐ＜０． ０５）；光、电镜显示经过缺血预处理的心肌细胞损伤轻。结论：缺血预处理能明显减轻兔未成熟心肌缺血再灌注损伤，改善再灌注后心脏功能的恢复，其机制可能与保存再灌注后心肌细胞中ＡＴＰ含量有关。Objective: To investigate whether immature hearts experiencing global ischemia and reperfusion injury could be protected by ischemic preconditioning( IPC) and probe the possible mechanism. Methods : Aerobically perfused in Langendorff mode at 39t ,isolated immature rabbit hearts( 14 -21 days old)were subjected to a IPC stimulus consisting of 5 minutes of global ischenmia plus 10 minutes of reperfusion. This was followed by 45 minutes of global ischemia and 40 minutes of reperfusion. Left ventricular developed pressure( LVDP) , change of myocardial enzyme (CK - MB) in the coronary effluent, myocardial energy metabolism and morphology were de termined. Cold crystalloid cardioplegia was used to cause the hearts to arrest before the prolonged global I/R. Re sults : The LVDP value in IPC group was significantly higher than that in control. The CK - MB leakage in IPC group was decreased significantly (24.58 ± 5.09 U/L versus 32.80 ± 5.32 U/L in controls P<0. 01). The myocardial levels of ATP in preconditioned group at the end of the reperfusion was significantly preserved(208. 14 ±24. 2ug /g versus 174.52 ± 15. 69ugg/g in controls P<0. 05). Light and electron microscopic findings of myocardium showed the preconditioned hearts were less severely damaged. Conclusion : IPC has a protective effect on the immature rabbit hearts suffering from global I /R injury,which is possibly connected with the preservation of ATP level in myocardium tissue.

关 键 词：缺血预处理 未成熟 心麻痹液 心肌缺血 

分 类 号：R542.2[医药卫生—心血管疾病]