低温环境对兔心肌功能的影响  

Influence of Hypothermia on the Myocardial Structure and Function of Rabbit

作　　者：张筠[1] 曹军英[1] 蔡慧红[1] 于馨[1] 高越[1] 

机构地区：[1]沈阳军区总医院特诊科,辽宁沈阳110016

出　　处：《创伤与急危重病医学》2015年第4期218-220,231,共4页Trauma and Critical Care Medicine

基　　金：全军"十一.五"课题科技攻关项目(08G001);辽宁省2009年自然科学基金(20092091)

摘　　要：目的应用超声心动图评价低温环境对局部心肌功能的影响,研究低温所致心肌酶和心肌细胞病理结构的改变。方法将24只新西兰大白兔随机分为常温组和低温组,每组12只。在心尖四腔心切面,分别测量二尖瓣环室间隔及左室侧壁的收缩期峰值运动速度(Sm)、收缩期峰值应变率(SRs)、舒张早期峰值运动速度(Em)及舒张早期峰值应变率(SRe)。测定2组兔的心肌酶浓度。取兔心室肌肉组织,送病理活检。结果低温组左室二尖瓣环两侧壁的SRe及室间隔侧的Em均明显低于常温组,差异有统计学意义(P<0.05)。低温组左室二尖瓣环两侧的SRs及Sm也低于常温组,但差异无统计学意义。低温组血液标本中肌酸激酶及肌酸激酶同工酶明显高于常温组,差异有统计学意义(P<0.05);乳酸脱氢酶及天门冬氨酸氨基转移酶与常温组无明显差别。病理结果显示,心肌细胞出现不同程度的变性损伤。结论低温环境可引起兔心肌局部舒张功能的明显降低,以及心肌细胞非致死性损伤。Objective To evaluate the effect of hypothermia on the regional myocardial function by echocardiography and study the changes of myocardial combination enzyme and pathology structure of myocardial cells in hypothermia. Methods A total of 24 New-Zealand rabbits were randomly divided into two groups,common temperature group（ CT group,n = 12）and hypothermia group（ HT group,n = 12）. Peak systolic velocity（ Sm）,peak systolic strain rate（ SRs）,peak diastolic velocity（ Em） and peak diastolic strain rate（ SRe） were obtained from 2 mitral annulus sites from apical 4-chamber views.We tested the myocardial combination enzyme of both groups and took the ventricular tissue for pathological biopsy. Results With HT,peak early diastolic strain rate（ SRe） in both side of mitral annulus and peak early diastolic velocity（ Em） in interventricular septum decreased significantly（ P〈0. 05）,while peak systolic strain rate（ SRs） and peak systolic velocity（ Sm） in both sides of mitral annulus decreased lightly. Compared with the CT group,the HT group had significantly higher CK and CK-MB level,while the CT and HT did not differ significantly in LHD and AST level. Pathology results showed certain degree of degeneration injury in HG. Conclusion Hypothermia negatively affects diastolic function and induces nonlethal damage in myocardial cells.

关 键 词：低温环境 变性损伤 心肌酶 心肌细胞 非致死性损伤 

分 类 号：R540.45[医药卫生—心血管疾病]