温血诱导心脏停跳及复跳前再灌注对幼兔心肌的保护作用  

Myocardial Protection Effects of Warm Induction and Reperfusion with Blood Cardioplegia in Neonatal Rabbits

作　　者：蓝斌[1] 张希[2] 李木泉[1] 姚尖平[2] 

机构地区：[1]汕头市中心医院心胸外科,广东汕头515031 [2]中山大学附属第一医院心胸外科,广东广州510080

出　　处：《中山医科大学学报》2002年第5期394-396,400,共4页Academic Journal of Sun Yat-sen University of Medical Sciences

基　　金：汕头市重点科技基金资助项目 (2 0 0 0 -90 )

摘　　要：【目的】探讨温血诱导停跳及复跳前再灌注对未成熟心肌的保护作用。【方法】 16只 (2～ 3周 )健康幼兔各分为对照组 (冷晶体停跳液诱停 )和实验组 (温血诱停及再灌注 )。采用幼兔离体心脏模型 ,分别检测两组心肌超氧物歧化酶(SOD)、丙二醛 (MDA) ,腺苷三磷酸 (ATP)水平 ,心肌水质量分数wc,wt和心肌细胞超微结构的变化。【结果】心肌的MDA质量摩尔浓度mc,MDA,实验组 (331 4 2± 4 0 4 0 )nmol/ g、对照组 (334 4 2± 4 1 4 7)nmol/ g(P >0 0 5 ) ;心肌的SOD比活性z/m ,实验组 (397 5± 4 8 8)U/ g、对照组 (397 2± 4 8 7)U/g(P >0 0 5 ) ;心肌的ATP质量分数wATP,实验组 (139 3± 31 9) μg/g、对照组 (138 7± 2 1 5 ) μg/g(P >0 0 5 ) ;心肌水质量分数 ,实验组 (6 3 81± 2 4 5 ) %、对照组 (6 6 96± 2 4 4 ) % (P <0 0 1)。温血诱停及复跳前再灌注后 ,心肌细胞线粒体、细胞核等超微结构均得到较好保护。【结论】温血诱导停跳及再灌注和冷晶体停跳液 ,对未成熟心肌能量代谢和减轻缺血再灌注损伤方面的保护作用相同 ;但前者对心肌细胞超微结构的保护作用较好 。To investigate the myocardial protection effects of warm induction and reperfusion with blood cardioplegia in immature myocardium. Sixteen neonatal rabbits, 2～3 weeks old, were divided into two groups: the control group (cold induction with crystalloid cardioplegia) and the experimental group (warm induction and reperfusion with blood cardioplegia). An isolated heart model of neonatal rabbits was astablished in this study. Some indexes such as myocardial superoxide dismutase(SOD), malondialdehyde(MDA) content, adenosine triphosphate(ATP) content, water content(mass), and myocardial ultrastructure were observed in these two groups. Molality of myocardial MDA was (331 42±40 40) nmol/g in the experimental group and (334 42±41 47) nmol/g in the control group respectively(P>0 05); Specific activity of myocardial SOD was (397 5±48 8) U/g in the experimental group versus (397 2±48 7) U/g in the control group (P>0 05); Mass fraction of myocardial ATP was (139 3±31 9) μg/g in the experimental group and (138 7±21 5) μg/g in the control group (P>0 05); Mass fraction of myocardial water was (63 81±2 45)% in the experimental group and (66 96±2 44) % in the control group (P<0 01). The myocardial ultrastructure was better protected by warm induction and reperfusion with blood cardioplegia. [Conclusion] Both warm induction and reperfusion with blood cardioplegia or with cold crystalloid cardioplegia can improve myocardial energy metabolism and reduce the ischemia reperfusion injury for immature myocardium. The myocardial ultrastructure could be better protected by warm induction and reperfusion with blood cardioplegia.

关 键 词：心血管模型 人工心脏停搏 心肌再灌注 心肌再灌注损伤 心麻痹液 外科学 生理学 

分 类 号：R654.2[医药卫生—外科学]