经颈动脉插管行Krebs⁃Henseleit液预交换的离体心脏灌注技术  

Isolated cardiac perfusion technique with Krebs⁃Henseleit Buffer pre⁃exchange via carotid artery catheter⁃ization

作　　者：郭书栋 李彤[2,3] 米睿[2] 郑伟锋 胡晓旻[2] 齐振昌 宋元申 王成蕊 GUO Shudong;LI Tong;MI Rui;ZHENG Weifeng;HU Xiaomin;QI Zhenchang;SONG Yuanshen;WANG Chengrui(The Third Central Clinical School of Tianjin Medical University,Tianjin 300170,China)

机构地区：[1]天津医科大学三中心临床学院,天津300170 [2]天津市第三中心医院心外科,天津300170 [3]天津市人工细胞重点实验室,卫生部人工细胞工程技术研究中心,天津300170

出　　处：《实用医学杂志》2020年第10期1305-1310,共6页The Journal of Practical Medicine

基　　金：天津市自然科学基金项目(编号:17JCQNJC10000);天津市科技计划项目(编号:18YFZCSY01080);天津市科技计划项目(编号:16ZXMJSY00200)。

摘　　要：目的探索一种能够在大鼠心脏离体过程中实现持续灌注的心脏离体灌注技术。方法将20只雄性SD大鼠随机分为传统对照组(T组,n=10)和改进手术组(M组,n=10),分别用Langendorff传统离体心脏方法和改进手术方法将心脏离体后灌注,通过观察记录心脏复跳、稳定时间,冠脉流量,各时间点心率(HR)以及心律失常评分情况来比较两组离体心脏功能。结果两组心脏离体后均可成功复跳;与传统组相比,改进组离体心脏存活时间显著长于传统组(P<0.001),心脏全程无停止跳动;改进组冠脉流量在1、30 min、1、2 h时显著高于传统组,差异具有统计学意义(P<0.05);改进组离体心脏于再灌注1、5、10、15、30 min、1、2 h时的心率显著高于传统组,差异具有统计学意义(均P<0.001);改进组所有离体心脏全程均未有心律失常发生,心律失常评分显著低于传统组,差异具有统计学意义(P<0.001)。结论经颈动脉插管行Krebs⁃Henseleit液(K⁃H液)预交换的心脏离体灌注技术能够实现不停跳、不停灌注、“零缺血”时间离体心脏,避免了心脏缺血再灌注的发生,更有利于离体后心脏功能的保持,提高离体心脏的存活时间,可为心脏离体研究提供更合适的技术手段。Objective To explore an isolated cardiac perfusion technique that enables continuous perfusion during rat heart isolation.Methods A total of 20 male SD rats were randomly divided into two groups:traditional control group(T group,n=10)and modified operation group(M group,n=10),The heart is perfused in vitro by Langendorff traditional isolated heart method and modified surgical method,respectively.The cardiac function of the two groups was compared by observing and recording cardiac re⁃beating,stable time,coronary flow,heart rate(HR)and arrhythmia score at each time point.Results In both two groups,heartbeats were restored successfully after being isolated from the body.The survival time of the isolated heart in the modified group was significantly longer than that in the traditional group(P<0.001),The heart in the modified group never stops beating.The coronary flow in the modified group was significantly higher than that in the traditional group at 1 min,30 min,1 h and 2 h,and the difference was statistically significant(P<0.05,respectively).The heart rate of isolated heart in the modified group was significantly higher than that in the traditional group at 1 min,5 min,10 min,15 min,1 h and 2 h(all P<0.001).There was no arrhythmia in all isolated hearts in the modified group,and the score of arrhythmia in the modified group was significantly lower than that in the traditional group(P<0.001).Those results showed that the modified Isolated heart technique play a better protective effect on the heart in vitro.Conclusions Isolated cardiac perfusion technique with Krebs⁃Henseleit Buffer pre⁃exchange via carotid artery catheterization could achieve continuous beating,continuous perfusion,“zero ischemia”time to isolated heart.It avoids the occurrence of heart ischemia⁃reperfusion,is more beneficial to the maintenance of car⁃diac function after isolation,improves the survival time of isolated heart,and provides a more suitable technical means for the study of heart in vitro.

关 键 词：大鼠 离体心脏灌注 颈动脉-主动脉交换灌注 持续灌注 不停跳 LANGENDORFF 

分 类 号：R331[医药卫生—人体生理学]