缺血预处理对兔离体心脏长期保存的心肌保护作用  

Effectiveness of ischemic preconditioning in long term isolated rabbit heart preservation

作　　者：周明[1] 崔仲奇[1] 王凤林[1] 

机构地区：[1]中日友好医院心血管外科,北京100029

出　　处：《中华实验外科杂志》2002年第3期211-213,共3页Chinese Journal of Experimental Surgery

摘　　要：目的　观察缺血预处理对离体心脏长期保存的心肌保护作用。方法　将 2 4只家兔随机分为 4组 ,每组 6只 ,分成空白对照组、预处理组、保存组和预处理后保存组。离体兔心脏用Langendorff装置灌注稳定后 ,分别给予缺血预处理后再灌注、心脏保存 1 8h后再灌注及缺血预处理后再经 1 8h保存后再灌注 60min ,观察左室收缩功能的恢复率、冠脉回流液中碱性磷酸激酶(CK)、乳酸脱氢酶 (LDH)的浓度以及心肌形态结构改变。结果　预处理组同空白对照组相比 ,各项指标差异无显著性 (P >0 .0 5)。单纯保存组同对照组相比 ,左室收缩功能明显减弱 ,冠脉回流液中心肌酶的漏出明显增加 ,光镜及电镜观察心肌损伤严重。而经预处理后再保存组 ,左室收缩功能的恢复率较单纯保存组有明显提高 [(51 .9± 7.5) %比 (36 .6± 4 .9) % ,P <0 .0 5] ,心肌酶漏出明显减少 [CK :(31 2± 52 )IU/L比 (642± 1 0 8)IU/L ;LDH :(2 9± 9)IU/L比 (76± 1 0 )IU/L ,P <0 .0 5] ,光镜及电镜观察 ,心肌损伤程度明显减轻。结论　缺血预处理过程本身对心肌细胞无明显损伤 ,是比较安全的 ;Objective To assess whether the protective effect of ischemic preconditioning (IP) can be adapted for long term isolated rabbit heart preservation.Methods Isolated rabbit hearts were perfused with oxygen bicarbonated Krebs Henseleit buffer in the Langendorff apparatus for 35?min (control group and preservation group),or perfused for 20?min,followed by 5?min of global ischemia and 10?min of buffer perfusion (IP group and IP preservation group).In the group IP and IP preservation group,the hearts were then arrested and preservated for 18?h with St.thoma's cardioplegic solution at 4?℃,followed by 60?min normothermic reperfusion.As controls,hearts were perfused continuously for 60?min without being preservated in control group C and preservation group.Recovery of contractive function,myocardium enzyme leakage,and morphologic change were compared.Results After 18?h cold storage,the hearts in the preservation group and IP preservation showed dysfunction and injury to varyed degrees than the heart in group A and B.But the heart undergoing preconditioning in group IP P showed better recovery of left ventricular developed pressure [(51.9±7.5)% vs (36.6±4.9)%],less leakage of enzyme [CK:(312±52)?IU/L vs (642±108)?IU/L,LDH:(29±9I)?U/L vs (76±10)?IU/L],and slight injury in electron microscopy than those in group P.Conclusion Our study demonstrted ischemic preconditioning can protect isolated rabbit heart from injury caused by long term cold storage.

关 键 词：缺血预处理 兔 离体心脏 长期保存 心肌保护作用 

分 类 号：R654.2[医药卫生—外科学]