果糖二磷酸钠预处理和后处理对大鼠离体心脏缺血再灌注损伤的影响  

Effects of preconditioning and postconditioning with fructose-1, 6-bisphosphate on ischemia-reperfusion injury in isolated rat hearts

作　　者：汪芳俊[1] 胡建华[1] 余庆波[1] 左友波[1] 陈昌林[1] 

机构地区：[1]川北医学院附属医院麻醉科,四川省南充市637000

出　　处：《中华麻醉学杂志》2015年第5期624-627,共4页Chinese Journal of Anesthesiology

基　　金：四川省卫生厅课题（120444）

摘　　要：目的：评价果糖二磷酸钠预处理和后处理对大鼠离体心脏缺血再灌注损伤的影响。方法清洁级健康雄性SD大鼠，月龄5～6月，体重210～240 g，取Langendorff离体心脏灌注模型制备成功的心脏60个，采用随机数字表法分为4组（ n＝15）：对照组（ C组）、果糖二磷酸钠预处理组（ Fpr组）、缺血再灌注组（ I∕R组）和果糖二磷酸钠后处理组（ Fpo组）。平衡30 min后，C组采用K-H液持续灌注100 min，余3组灌注K-H液10 min，Fpr组灌注含有果糖二磷酸钠5 mmol∕L的K-H液10 min。 I∕R组、Fpr组和Fpo组灌注St． Thomas停跳液20 ml使心脏停跳，同时停灌。心脏停灌30 min后，IR组和Fpr组再灌注K-H液60 min，Fpo组先灌注含有果糖二磷酸钠5 mmol∕L的K-H液10 min，再灌注K-H液50 min。于平衡末（ T0）、停灌注前1 min（ T1）、再灌注5、15、30和60 min（ T2-5）时记录HR、左室发展压（LVDP）和左室舒张末压（LVEDP），T0和T5时测定冠脉流量（CF），收集冠脉流出液，测定CK和LDH活性。 T5时光镜下观察心肌组织病理学结果。结果与C组比较，I∕R组、Fpr组和Fpo组T2～5时HR和LVDP降低，LVEDP升高，I∕R组和Fpr组T5时CF降低，I∕R组、Fpr组和Fpo组冠脉流出液CK和LDH活性升高（P＜0．05）；与I∕R组比较，Fpr和Fpo组T2～4时HR和LVDP 升高， LVEDP降低，Fpr组和Fpo组T5时CF升高，冠脉流出液CK和LDH活性降低（ P＜0．05）；与Fpr组比较，Fpo组T2～5时HR和LVDP 升高，LVEDP 降低，T5时CF升高，冠脉流出液CK和LDH活性降低（ P＜0．05）。 Fpo组心肌细胞病理学损伤较Fpr组减轻。结论果糖二磷酸钠预处理和后处理均可减轻大鼠离体心脏缺血再灌注损伤，改善心功能，后处理效应优于预处理。Objective To evaluate the effects of preconditioning and postconditioning with fructose-1, 6-bisphosphate （FBP） on ischemia-reperfusion （I∕R） injury in isolated rat hearts. Methods Healthy male Sprague-Dawley rats, aged 5-6 months, weighing 210-240 kg, were heparinized and anesthetized with isoflurane. Their hearts were excised and retrogradely perfused in a Langendorff apparatus with K-H solution saturated with 95% O2 and 5% CO2 at 37-38 ℃ in a Langendorff apparatus. Sixty isolated rat hearts were randomly divided into 4 groups （ n= 15 each ） using a random number table： control group （ group C） , FBP preconditioning group （ group Fpr） , I∕R group, and FBP postconditioning group （ group Fpo） . After 30 min of stabilization, the hearts were continuously perfused with K-H solution for 100 min in group C, with K-H solution for 10 min in the other three groups, or with K-H solution containing FBP 5 mmol∕L for 10 min in group Fpr. In I∕R, Fpr and Fpo groups, the hearts were perfused with cardioplegic solution 20 ml to induce cardiac arrest, and perfusion was stopped at the same time. After 30 min of suspension of perfusion, I∕R and Fpr groups were perfused with K-H solution for 60 min, and group Fpo was first perfused with K-H solution containing FBP 5 mmol∕L for 10 min, and then perfused with K-H solution for 50 min. At the end of stabilization （ T0 ） , at 1 min before suspension of perfusion （ T1 ） , and at 5, 15, 30 and 60 min of reperfusion （ T2-5 ） , heart rate （ HR ） , left ventricular developed pressure （LVDP）, and left ventricular end-diastolic pressure （LVEDP） were recorded. At T0 and T5, the coronary flow （ CF） was measured, and the coronary effluent was collected for determination of creatine kinase （ CK） and lactic dehydrogenase （ LDH） activities. The histopathologic changes of myocardium were examined with light microscope at T5 . Results Compared to group C, HR and LVDP were significantly decreased, and LVEDP was increased at T2

关 键 词：果糖二磷酸盐类 缺血预处理 心肌再灌注损伤 缺血后处理 

分 类 号：R614[医药卫生—麻醉学]