含七氟醚HTK液对大鼠供体心脏再灌注时电生理稳定性的影响  

Effect of sevoflurane-containing HTK solution on electrophysiological stability of rat donor heart during reperfusion

作　　者：李伟超 高鸿 高巨 佘玉琦 王子君 刘艳秋 Li Weichao;Gao Hong;Gao Ju;She Yuqi;Wang Zijun;Liu Yanqiu(Collegeof Anesthesiology,Guizhou Medical University,Guiyang 550004,China;Department of Anesthesiology,Noah Jiangsu People's Hospital,Yangzhou 225000,China;Department of Anesthesiology,Affiliated Hospital of Guizhou Medical University,Guiyang 550004,China)

机构地区：[1]贵州医科大学麻醉学院,贵阳市550004 [2]苏北人民医院麻醉科,扬州市225000 [3]贵州医科大学附属医院麻醉科,贵阳市550004

出　　处：《中华麻醉学杂志》2018年第7期825-828,共4页Chinese Journal of Anesthesiology

摘　　要：目的评价含七氟醚HTK液对大鼠供体心脏再灌注时电生理稳定性的影响。方法雄性SD大鼠,体重280~320g,3月龄,制备供体心脏离体灌注模型。取供体心脏16个,采用随机数字表法分为2组(n=8):对照组(C组)采用HTK液作为保存液;七氟醚组(S组)采用含有2.5%七氟醚的HTK液作为保存液,2组分别在4℃低温下保存6h后开始再灌注,逐渐恢复灌注温度至37℃。记录心脏复跳时间和心律失常发生情况。于再灌注30和45min时记录HR和心肌外膜层及内膜层单相动作电位复极50%的时程(MAPD50)、单相动作电位复极90%的时程(MAPD90)、单向动作电位振幅(MAPA)和最大去极化速度(Vmax)以及早期后除极和延迟后除极的发生情况。结果与C组比较,S组心脏复跳时间缩短,室颤发生率和心律失常评分降低,室颤时程缩短,再灌注30和45min时心肌外膜层和内膜层MAPD50和MAPD90缩短(P<0.05),HR、Vmax、和MAPA差异无统计学意义(P>0.05)。2组均未见早期后除极和延迟后除极发生。结论含七氟醚HTK液可维持大鼠供体心脏再灌注时电生理稳定性,降低心律失常的发生。Objective To evaluate the effect of sevoflurane-containing HTK solution on electro-physiological stability of rat donor heart during reperfusion.Methods Male Sprague-Dawley rats,weighing 280-320g,aged 3months,in which a Langendorff-perfused isolated rat donor heart model was established,were used in this study.Sixteen donor hearts were obtained and divided into 2groups (n=8 each) using a random number table method :control group (group C)and sevoflurane group (group S).HTK solution was used as preservation solution in group C.HTK solution containing 2.5%sevoflurane was used as preservation solution in group S.Hearts were stored for 6h in the corresponding preservation solution at 4℃ and then reperfused,and the perfusion temperature was gradually restored to 37℃ in two groups.The time of spontaneous recovery of heart beat and development of arrhythmia were recorded.Heart rate, monophasie action potential (MAP)duration at 50%and 90%repolarization (MAPD50,MAPD90),MAP amplitude and maximum velocity and development of early after-depolarization and delayed after-depolarization were recorded at 30 and 45 min of reperfusion.Results Compared with group C,the time of spontaneous recovery of heart beat was significantly shortened,the incidence of ventrieular fibrillation and arrhyth-mia score were decreased,the ventricular fibrillation interval was shortened,and MAPDso and MAPD90 of epicardium and endocardium were shortened at 30and 45min of reperfusion (P<0.05),and no significant change was found in hear rate,maximum velocity or MAP amplitude in group S (P>0.05).Early after-depolarization and delayed after-depolarization were not found in two groups.Conclusion Sevoflurane-eontaining HTK solution can maintain electrophysiological stability of rat donor heart during reperfusion and decrease the occurrence of arrhythmia.

关 键 词：麻醉药 吸入 心脏移植 心脏电生理学 

分 类 号：R614[医药卫生—麻醉学]