一氧化碳高压干燥环境对离体兔心的保护效果  

Preservation with high-pressure carbon monoxide better protects ex vivo rabbit heart function than conventional cardioplegic solution preservation

作　　者：张钟[1,2,3] 肖泽周[1,2,3] 郭义龙[1,2,3] 周鹏宇[1,2,3] 朱平[1,2,3] 麦明杰[1,2,3] 郑少忆[1,2,3] 

机构地区：[1]广东省心血管病研究所 [2]广东省人民医院心外科 [3]广东省医学科学院,广东广州510180

出　　处：《南方医科大学学报》2015年第7期1008-1013,共6页Journal of Southern Medical University

基　　金：中华人民共和国科学技术部;国际科技合作项目(2010DFA32660)

摘　　要：目的：观察一氧化碳（CO）高压干燥环境对离体兔心的保护效果，与传统HTK液低温浸泡保存比较，为心脏移植提供一种新的保存方式。方法将85只新西兰兔随机分为3组，分别为空白对照组（n=5），CO组（n=40）和HTK组（n=40）。空白对照组在取下心脏后直接进行酶学检测，而两个保存组中，每组兔心在不同保存方式下（高压罐中干燥保存及HTK液中浸泡保存）分别保存2、4、6、8、10、14、18和24 h，每个时间点各5只。通过建立改良Langendorff离体兔心灌注模型，监测模型保存前后心肌舒缩功能变化情况，心律失常评分，检测CK、CK-MB等酶学指标，观察心肌超微结构改变。结果恢复灌注后30 min，（1）CO干燥组的心肌舒缩功能、心功酶和心律失常评分改变在短期保存（2-4 h）内与HTK浸泡组无明显差别，而在中长期保存（6-24 h）上， CO干燥组各项指标均优于HTK浸泡组；（2）保存24 h后2组心肌超微结构均存在明显改变，但CO干燥组心肌细胞内结构损伤较HTK浸泡组轻。结论 CO高压干燥环境确实对离体兔心具有保护作用，而且在长时间保存方面，CO高压干燥保存比HTK浸泡保存更有优势。Objective To investigate the protective effect of high-pressure carbon monoxide for preservation of ex vivo rabbit heart graft in comparison with the conventional HTK cardioplegic solution preservation. Methods Heart grafts isolated from 85 New Zealand rabbits were randomly divided into Naive group （n=5）, HTK group （n=40） and CO group （n=40）. The grafts underwent no preservation procedures in Naive group, preserved at 4 ℃ in HTK cardioplegic solution in HTK group, and preserved at 4℃in a high-pressure tank （PO2：PCO=3200 hPa：800 hPa） in CO group with Krebs-Henseleit solution perfusion but without cardioplegic solution. After preservation for 2, 4, 6, 8, 10, 14, 18, and 24 h, 5 grafts from the two preservation groups were perfused for 30 min with a modified Langendorff apparatus and examined for left ventricular systolic pressure （LVSP）, left ventricular diastolic pressure （LVDP）, arrhythmia score （AS）, myocardial ultrestructure, and cardiac enzyme profiles. Results After preservation for 6 to 24 h, the cardiac enzyme profiles and systolic and diastolic functions were significantly better in CO group than in HTK group, but these differences were not obvious between the two groups after graft preservation for 2 to 4 h. Significant changes in the myocardial ultrastructures occurred in the isolated hearts after a 24-h preservation in both CO and HTK groups, but the myocardial damages were milder in CO group. Conclusion Preservation using high-pressure carbon monoxide can better protect isolated rabbit heart graft than the conventional HTK preservation approach especially for prolonged graft preservation.

关 键 词：心脏保存 一氧化碳 干燥 细胞保护 

分 类 号：R654.2[医药卫生—外科学]