HeartCon型左心室辅助装置(LVAD)的持续性循环支持对实验动物肝肾功能的影响  

Influence of continuous circulatory support of HeartCon type left ventricular assist device(LVAD)on liver and kidney function in experimental animals

作　　者：刘天文 刘晓程[1] 刘志刚[1] 张杰民[1] Liu Tianwen;Liu Xiaocheng;Liu Zhigang;Zhang Jiemin(Chinese Academy of Medical Sciences and Peking Union Medical College,TEDA International Cardiovascular Hospital,Tianjin 300457,China)

机构地区：[1]中国医学科学院北京协和医学院,泰达国际心血管病医院,天津300457

出　　处：《国际生物医学工程杂志》2021年第6期465-469,共5页International Journal of Biomedical Engineering

基　　金：国家重点研发计划(2016YFC0103203,2017YFC111000)。

摘　　要：目的明确左心室辅助装置(LVAD)的持续循环支持是否对实验动物的肝肾功能造成不良影响。方法选取6只健康实验羊,植入HeartCon型LVAD。检测实验羊术前和术后70 d肝肾指标,包括尿素(UREA)、肌酐(CREA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)和总胆红素(TBIL),评估其肝肾功能变化。结果 6只实验羊术前的UREA、CREA、ALT、AST和TBIL水平分别为(4.60±1.51) mmol/L、(94.80±23.10) μmol/L、(16.20±6.87) U/L、(82.60±17.33) U/L和(0.52±0.25) μmol/L。与植入前相比,LVAD植入后实验羊的CREA水平的变化无统计学意义(均P>0.05)。LVAD植入后,实验羊的UREA、ALT、AST和TBIL水平在术后1~14 d内出现不同程度的升高;术后14 d后,各项指标恢复至术前水平;在研究终点时,实验羊的UREA、ALT、AST和TBIL水平分已恢复到术前水平,差异均无统计学意义(均P>0.05)。结论在使用HeartCon型LVAD进行持续循环支持的70 d内,未发现持续流动式LVAD对实验动物的肝肾功能造成不良影响的证据。HeartCon型LVAD能够提供足够的循环支持,以维持适当的末端器官功能。Objective To determine the adverse effects of continuous circulatory support on liver and kidney function in experimental animals using left ventricular assist devices(LVAD).Methods Six healthy experimental sheep were selected and implanted with HeartCon type LVAD.The liver and kidney indexes of experimental sheep before and 70 days after operation were detected,including urea(UREA),creatinine(CREA),alanine aminotransferase(ALT),aspartate aminotransferase(AST)and total bilirubin(TBIL),and the functional changes of liver and kidney were evaluated.Results The preoperative levels of UREA,CREA,ALT,AST and TBIL in the six experimental sheep were(4.60±1.51)mmol/L,(94.80±23.10)μmol/L,(16.20±6.87)U/L,(82.60±17.33)U/L,and(0.52±0.25)μmol/L,respectively.Compared with the indexes before the LVAD implantation,there was no significant change in CREA levels in experimental sheep after the implantation(all P>0.05).After the implantation,the levels of UREA,ALT,AST and TBIL increased to varying degrees within 1 to 14 days after the implantation.At the end of the study,the levels of UREA,ALT,AST and TBIL have returned to the preoperative levels,and the differences were not statistically significant(all P>0.05).Conclusions Within the 70 days of continuous circulatory support with HeartCon-type LVAD,no evidence of adverse effects of continuous flow LVAD on the liver and kidney function of experimental animals was found.HeartCon-type LVADs are able to provide adequate circulatory support to maintain proper end-organ function.

关 键 词：心力衰竭 心室辅助装置 持续循环支持 肝肾功能 动物实验 

分 类 号：R654.2[医药卫生—外科学] R-332[医药卫生—临床医学]