重组血红蛋白对冠心病大鼠氧供需平衡的影响  

Effects of recombinant hemoglobin on balance of oxygen supply and demand in coronary heart disease rats

作　　者：窦清理[1] 于湘友[1] 顾亚楠[1] 管源涵 郑宏[2] 

机构地区：[1]新疆医科大学第一附属医院重症医学科,新疆维吾尔自治区乌鲁木齐830054 [2]新疆医科大学第一附属医院麻醉科

出　　处：《中华危重病急救医学》2016年第12期1118-1122,共5页Chinese Critical Care Medicine

基　　金：新疆维吾尔自治区科技计划项目（201533102）

摘　　要：目的探讨两种重组血红蛋白（rHb1．1、rHb2．0）对冠心病（CHD）大鼠氧供需平衡的影响。方法按随机数字表法将雄性Wistar大鼠分为正常对照组、CHD模型组、人血清白蛋白（HSA）处理组、rHb1．1处理组、rHb2．0处理组，每组20只。高脂饮食联合脑垂体后叶素注射构建大鼠CHD模型。制模成功后股动脉抽血使平均动脉压（MAP）降至40mmHg（1mmHg=0．133kPa），随后各处理组于以60mL·kg^-1·h^-1的速率（20mL／kg）分别输入13．4％HSA、rHb1．1和rHb2．0进行复苏治疗。计算制模前和末次注射垂体后叶素后12h心电图ST段变化值，记录给药0、30、60、90和120min时MAP、心率（HR）、肠系膜上动脉血流量（QSMA）及动脉血气分析结果。实验末禁食12h，取血用酶法测定血清总胆固醇（TC）、甘油三酯（TG）含量；处死大鼠取心脏，光镜下观察心脏组织病理学改变。结果与正常对照组比较，模型组制模前后心电图ST段变化值明显增大，TC、TG明显升高。与模型组比较，rHb两组可明显降低趼段变化值，而HSA无此作用；rHb的短期输入对血脂无显著影响，但可减轻心肌组织病理学改变。与正常对照组比较，模型组MAP明显降低，HR明显加快，QSMA减慢，pH值、剩余碱（BE）、动脉血二氧化碳分压（PaCO2）、HCO3-明显下降。rHb1．1组和rHb2．0组MAP较HSA组升高更明显，且rHb2．0组给药90min和120min时MAP显著高于rHb1．1组（mmHg：80．9±3．3比69．4±4．9，79．2±4．0比69．1±3．7，均P〈0．05）；HSA、rHb1．1、rHb2．0处理组给药30minHR即降至正常，明显低于模型组（次／min：534±46、518±28、526±37比609±52，均P〈0．05）；rHb2．0组给药60、90、120min时QSMA较模型组明显增加（qv·mL^-1·min^-1：5．6±0．4比3．9±0．6，6．2±0．6比4．1±0．4，6．9±0．7比4．0±0．3，均P〈0．05），而HSA组和rHb1．1组QSMA与模型组比较差异均无统Objective To discuss the influence of two recombinant hemoglobin （rHb1.1 and rHb2.0） and human serum albumin （HSA） on oxygen supply and demand balance in rat with coronary heart disease （CHD）. Methods Male Wistar rats were randomly divided into normal control group, CHD model group, HSA treatment group, rHb1. 1 treatment group and rHb2.0 treatment group, 20 rats in each group. Rat model of CHD was established by high fat diet combined with pituitrin injection. The mean arterial pressure （MAP） decreased to 40 mmHg （1 mmHg = 0.133 kPa） after femoral arterial blood was drawn from the femoral arteries, and the rats were resuscitated with 13.4% HSA, rHb1.1 and rHb2.0, respectively, at the rate of 60 mL·kg^-1·h^-1（20 mL/kg）. The changes of electrocardiogram （ECG） ST-segment were calculated before model reproduction and at 12 hours after the last time injection of pituitrin. MAP, heart rate （HR）, superior mesenteric artery blood flow （QsMA） and arterial blood gas analysis were recorded at 0, 30, 60, 90 and 120 minutes after the administration. The blood was collected after 12-hour fasting, and serum total cholesterol （TC） and triglyceride （TG） were determined by enzymatic method. The pathological changes in cardiac tissue were observed with light microscope. Results Compared with the normal control group, the changes of ECG ST-segment and TC, TG of model group were significantly increased. Compared with the model group, rHb can significantly reduce the value of ST segment changes, and HSA has no such effect; rHb short-terua infusion has no significant effect on blood lipids, but can reduce myocardial pathological changes. Compared with the normal control group, the MAP of the model group decreased significantly, the HR was increased, the QSMA was slowed down, the pH value, the residual alkali （BE）,the arterial carbon dioxide partial pressure （PaCO2） and HCO3- were decreased significantly. MAP in rHbl. 1 group and rHb2.0 group were significantly higher than those in H

关 键 词：冠心病 重组血红蛋白 氧代谢平衡 损伤 缺血性 

分 类 号：R541.4[医药卫生—心血管疾病]