连续灌注不停跳心脏移植对供心的保护作用  

Protective effect of continuous perfusion of donor heart on rat cardiac allograft

作　　者：周涛[1] 向道康[1] 秦国伟[2] 

机构地区：[1]贵州省人民医院心脏外科,贵州省贵阳市550002 [2]广西壮族自治区人民医院心电诊断科

出　　处：《中国心血管病研究》2014年第10期936-938,共3页Chinese Journal of Cardiovascular Research

基　　金：贵州省科技攻关项目（项目编号：黔科合SY[2010]3119号）

摘　　要：目的 通过建立大鼠同种异位供心停跳心脏移植模型与连续血液灌注供心不停跳心脏移植模型,探讨连续灌注不停跳心脏移植对供心的影响.方法 建立大鼠同种异位连续灌注心脏不停跳心脏移植模型（不停跳移植组）和改良Heron法建立大鼠异位心脏移植模型（停跳移植组）.移植成功后2h检测受体外周血肌酸激酶同工酶（CK-MB）和心肌肌钙蛋白I（cTnI）含量,测定供心心肌脂质过氧化终产物丙二醛（MDA）、过氧化物歧化酶（SOD）含量,电镜观察心肌结构变化,并观察心肌凋亡情况.结果 连续灌注心脏不停跳移植组受体外周血CK-MB及cTnI含量低于停跳移植组,差异有统计学意义（P＜0.05）.与停跳移植组比较,不停跳移植组心肌MDA含量相对较少,SOD含量相对较多,心肌细胞凋亡指数较小,差异均有统计学意义（P＜0.05）.不停跳移植组心肌线粒体等结构损伤相对较轻.结论 心脏不停跳技术能有效减轻心脏移植供心的脂质过氧化反应,保护心肌线粒体,抑制心肌细胞凋亡,可减轻心脏移植供心的再灌注损伤.Objective To investigate the protective effect of continuous perfusion of donor heart on rat cardiac allograft in heart transplantation model. Methods To establish the rat heterotopic cardiac beating heart transplantation model （beating heart group） and modified Heron＇s transplantation model （control group）. The peripheral blood CK-MB and cTnl content at 2 h after the success of the establishment of heart transplantation model were measured. The level of MDA, SOD, and myocardial structural, myocardial apoptosis were observed in two groups. Results CK-MB and cTnI levels of peripheral blood were lower in beating heart group than those in the control group （P〈0.05）. Myocardial MDA concentration in beating heart group was significantly lower than that in control group, while SOD concentration was significantly higher than that in control group. The myocardial mitochondria damage in beating heart group was significantly less than those in control group, and apoptotic index of myocardial cells was also significantly lower than that in control group（P〈0.05 ）. Conclusion The continuous perfusion of donor heart exerts myocardial protection of donor heart by reducing the lipid peroxidation, protecting myocardial mitochondria, and inhibiting myocardial apoptosis.

关 键 词：心脏移植 心肌保护 连续灌注 心脏不停跳 

分 类 号：Q95-33[生物学—动物学] R654.2[医药卫生—外科学]