体外循环缺血-再灌注心肌肌钙蛋白I丢失与心功能障碍的关系  

Relationship Between Myocardial Troponin I Deletion and Heart Dysfunction During Myocardial Ischemia-reperfusion with Cardiopulmonary Bypass.

作　　者：隋东虎[1] 石应康[1] 王兰兰[2] 李立新[2] 王儒蓉[3] 刘斌[3] 

机构地区：[1]华西医科大学附属第一医院胸心外科,成都610041 [2]华西医科大学附属第一医院临床免疫室 [3]华西医科大学附属第一医院麻醉科

出　　处：《中国胸心血管外科临床杂志》2002年第4期269-271,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金资助项目 (3 0 2 70 5 67);中国博士后科学基金资助 (中博基 [2 0 0 0 ] 2 3 )~~

摘　　要：目的　探讨体外循环缺血 -再灌注心肌肌钙蛋白 I(Tn I)丢失与心功能障碍的关系。　方法　 12条雄性杂种狼犬 ,按体外循环升主动脉阻断时间不同分为两组 :组 (n=6 ) :主动脉阻断 2 5分钟 ;组 (n=6 ) :主动脉阻断 15 0分钟。分别于转流前、主动脉开放后 10分钟、30分钟、6 0分钟时测定动脉和冠状静脉窦血清 Tn I浓度 ,同时监测围术期冠状静脉窦血流量和血流动力学。　结果　再灌注后冠状静脉窦血清 Tn I浓度持续高于动脉血清 Tn I浓度 (P<0 .0 1) ,提示心肌丢失 Tn I。组 与组 比较 ,组 心肌 Tn I丢失水平更显著 ,且终止体外循环后心脏指数、每搏指数、左心室每搏作功指数均显著降低 (P<0 .0 5 )。　结论　体外循环缺血 -再灌注心肌 Tn I丢失程度与心功能障碍的发生密切有关 ,提示心肌细胞 Tn I丢失很可能是导致缺血后心肌功能障碍的分子基础之一。ObjectiveTo explore the relationship between myocardial troponin I (TnI) deletion and heart dysfunction during myocardial ischemia-reperfusion with cardiopulmonary bypass (CPB). MethodsTwelve male mongrel wolf dogs undergoing CPB were divided into two groups, groupⅠ (n=6), aortic cross clamping for 25min and group Ⅱ (n=6), aortic cross clamping for 150min. Arterial and coronary sinus serum TnI concentration, and coronary sinus flow and systemic hemodynamics were detected at pre-bypass, after aortic off-clamping 10min, 30min and 60min respectively. ResultsAfter myocardial reperfusion, coronary sinus blood serum TnI concentrations were consistently higher than arterial TnI concentration (P<0.01), indicating net TnI release by myocardium. Comparison with group Ⅰ, net TnI delection levels in group Ⅱ was markedly increased, while cardiac index (CI), stroke volume index (SVI) and left ventriclar stroke work index (LVSWI) were all significantly decreased after weaning from CPB(P<0.05). ConclusionsThe extent of myocardial TnI deletion is closely associated with heart dysfunction after myocardial ischemia-reperfusion with CPB. Myocardial TnI deletion is probably an important molecular basis resulting in postischemic myocardial dysfunction.

关 键 词：体外循环 缺血-再灌注 心肌 肌钙蛋白I 心功能障碍 

分 类 号：R654.2[医药卫生—外科学]