控制性氧灌注对犬体外循环心肌的保护作用  

Protective effect of controlled oxygen reperfusion on heart with cardiopulmonary bypass in dogs

作　　者：刘海[1] 陈光献[2] 郑红升[4] 梁孟亚[2] 荣健[3] 吴钟凯[2] 

机构地区：[1]郑州大学第一附属医院心血管外三科,450052 [2]中山大学附属第一医院心外二科,广州510080 [3]中山大学附属第一医院体外循环科,广州510080 [4]河南省胸科医院心血管二病区,郑州450003

出　　处：《中华实验外科杂志》2017年第1期79-81,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨控制性氧灌注对体外循环心肌的保护作用及其机制。方法12条健康犬随机分为对照组和实验组，建立体外循环模型。对照组全程吸氧浓度（FiO2）80%；实验组在主动脉开放后即刻调整FiO2为40%，随后每5 min依次上调10%直至80%，其余时段均维持FiO2在80%。两组犬在麻醉后、主动脉开放前、后5、10、15、20、25 min以及实验结束分别检测动脉血氧分压（PaO2）。麻醉后（T1）、实验结束（T2）分别获取血液标本，然后处死犬获取左室心肌标本。酶联免疫吸附法试剂盒检测血浆白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）含量。电化学发光免疫分析系统检测血浆心肌肌钙蛋白T（cTnT）含量。反转录-聚合酶链反应（RT-PCR）检测心肌组织高迁移族蛋白B1（HMGB1） mRNA表达，Western blot检测心肌组织HMGB1蛋白表达。结果实验组PaO2在主动脉开放后5、10、15、20 min均明显低于对照组（P＝0.032、0.021、0.046、0.013）。两组血浆IL-6、TNF-α和cTnT含量在T1时点处于较低水平（168.51±21.47比168.93±22.87；72.19±2.11比76.21±6.50；0.01比0.01），且两组差异无统计学意义（P＝0.200、0.077、0.357）。T2时点两组血浆IL-6、TNF-α和cTnT含量均较T1时点升高，但实验组血浆IL-6、TNF-α和cTnT含量低于对照组（609.36±52.37比408.65±43.45；255.09±10.15比174.09±8.65；3.18±1.64比1.54±0.92），差异有统计学意义（P＝0.028、0.034、0.039）。与对照组比较，HMGB1 mRNA和HMGB1蛋白在实验组中表达下调，差异有统计学意义（P＝0.026、0.033）。结论控制性氧灌注对体外循环心肌具有一定的保护作用，其机制可能与下调HMGB1表达有关。Objective To observe the protective effects of controlled oxygen reperfusion （COR） on the hearts with cardiopulmonary bypass （CPB） and its possible mechanism. Methods Twelve canines were randomized into two groups： control group and test group. The CPB model was established. The animals in the control group received 80% fraction of inspired oxygen （FiO2） throughout the whole procedure. The animals in the test group received 40% FiO2 immediately at the declamping of aorta, and an additional 10% every 5 min later until 80% FiO2 was reached, and other procedures were the same as those in the control group. Arterial oxygen partial pressure （PaO2） was analyzed after anesthesia, before aortic declamping, 5, 10, 15, 20 and 25 min after aortic declamping, and at the end of the experiment. The blood samples were obtained after anesthesia （T1） and at the end of the experiment （T2）, respectively. The animals were then sacrificed to obtain the left ventricle samples. The levels of interleukin-6 （IL-6） and tumor necrosis factor-α （TNF-α） in plasma were measured by enzyme-linked-immunosorbent assay. The level of plasma cardiac troponin T （cTnT） was measured by ECL immunoassay system. The expression of high mobility group protein B1 （HMGB1） mRNA and protein in myocardial tissue was detected by reverse transcriptase-polymerase chain reaction （RT-PCR） and Western blotting. Results PaO2 was significantly lower in the test group than that in the control group at 5, 10, 15 and 20 min after aortic declamping （P=0.032, 0.021, 0.046, 0.013）. The levels of IL-6, TNF-α and cTnT in plasma were low and there was no significant difference between the two groups at T1 （168.51±21.47 vs. 168.93±22.87; 72.19±2.11 vs. 76.21±6.50; 0.01 vs. 0.01）. The levels of IL-6, TNF-α and cTnT in plasma increased from T1 to T2. The levels of IL-6, TNF-α and cTnT in the test group were lower than those in the control group （609.36±52.37 vs. 408.65±43.45; 255.09±10.15 vs. 174.09±8.65; 3.18±1.

关 键 词：控制性氧灌注 体外循环 白细胞介素-6 肿瘤坏死因子-Α 高迁移族蛋 白B1 

分 类 号：R654.1[医药卫生—外科学]