脑死亡五指山小型猪模型的心脏损伤及其机制的研究  

Research on cardiac injury of brain death in Wuzhishan miniature pig models and its mechanism

作　　者：陈玉超[1] 滕亮[1] 王清卿[1] 曹经琳[1] 窦剑[1] 

机构地区：[1]河北医科大学第三医院肝脏外科,050051

出　　处：《器官移植》2016年第3期187-190,209,共5页Organ Transplantation

基　　金：河北省重大医学科研课题(zd2013031)

摘　　要：目的探讨缓慢颅内加压法建立脑死亡猪模型的心脏损伤及其机制。方法五指山小型猪16只,随机分为实验组及假手术组。实验组采用颅内加压法建立脑死亡模型,假手术组仅行开颅置管术,不做颅内加压。监测手术前后心电图变化、并监测术前及术后0、3、6、12 h血清肌酸激酶(CK)、肌酸激酶同功酶(CK-MB)及乳酸脱氢酶(LDH)水平的变化。结果实验组随着脑死亡时间延长,心电幅度下降,T波幅度增大。术后0、3、6 h,实验组的CK水平均高于假手术组(均为P<0.05)。术后6、12 h,实验组的CK-MB水平高于假手术组(均为P<0.05)。术后0、3、6、12 h,实验组的CK和CK-MB水平均高于术前(均为P<0.05)。术后0、6、12 h,假手术组的LDH水平均低于术前(均为P<0.05)。结论脑死亡模型猪在脑死亡状态下心电图呈特异性改变,其机制可能与心肌损伤有关。Objective To evaluate the effect and mechanism of brain death on cardiac injury in pig models established by gradually increasing intracranial pressure. Methods Sixteen Wuzhishan miniature pigs were randomly divided into the experimental and sham surgery groups. In the experimental group,animal models with brain death were established by increasing intracranial pressure. In the sham surgery group,merely cranial catheterization was performed. The changes in the electrocardiogram（ ECG） were monitored before and after surgery. The variations of the serum levels of creatine kinase（ CK）,creatine kinase isoenzyme（ CK-MB） and lactate dehydrogenase（ LDH） were quantitatively measured before and at 0,3,6,12 h after surgery. Results Along with the duration of brain death,decline of ECG amplitude and elevation in T-wave amplitude were observed. At 0,3 and 6 h after surgery,the levels of CK in the experimental group were significantly higher than those in the sham surgery group（ all P〈0. 05）. At 6 and 12 h after surgery,the CK-MB levels in the experimental group were considerably higher than those in the sham surgery group（ all P〈0. 05）. At postoperative 0,3,6 and 12 h,the levels of CK and CK-MB in the experimental group were enhanced compared with preoperative levels（ all P〈0. 05）. However,the LDH levels at 0,6 and 12 h after surgery were significantly lower than preoperative levels in the sham surgery group（ all P〈0. 05）. Conclusions Brain death pig models present with specific changes in ECG under the status of brain death,probably related to the myocardial damage.

关 键 词：脑死亡 器官捐献 肌酸激酶 肌酸激酶同功酶 乳酸脱氢酶 

分 类 号：R617[医药卫生—外科学] R-332[医药卫生—临床医学]