缺血预处理联合停搏液对未成熟兔心脏的保护作用  

Ischemic preconditioning plus cardioplegia in immature rabbit hearts

作　　者：闵苏[1] 朱斌[1] 龙村[2] 温福[2] 张燕[2] 史世勇[2] 

机构地区：[1]重庆医科大学附属第一医院麻醉科,400016 [2]中国医学科学院阜外医院麻醉体外循环研究室,北京100037

出　　处：《重庆医学》2003年第2期179-181,共3页Chongqing medicine

摘　　要：目的　利用Langendorff模型研究缺血预处理 (IschemicPreconditioning,IPC)联合高钾停搏液对兔未成熟心脏缺血再灌注损伤的影响。方法　幼兔 (14～ 2 1d)离体灌注心脏 ,经历 5min缺血、10min再灌的IPC处理后 ,使用St.ThomasⅡ号液使其停跳 ,观察其在生理体温 (39℃ )下接受 4 5min缺血、4 0min再灌注后血流动力学、冠脉流出液心肌酶及心肌能量变化。结果　IPC联合高钾停搏液组较单纯高钾停搏液组再灌注后心率 (HR)、冠脉流出量 (CF)、左室发展压 (LVDP)及左室最大上升和下降速率 (±dp/dt)的恢复率明显改善 ,并保存了心肌ATP含量 ,减少了肌酸磷酸激酶同工酶 (CK MB)漏出。Objective We investigated whether immature hearts experiencing global ischemia and reperfusion injury could be protected by ischemic preconditioning (IPC) under the use of cardioplegia. Methods Aerobically perfused in Langendorff mode at 39℃, isolated immature rabbit hearts (14～21 days old) were subjected to a IPC stimulus consisting of 5 minutes of global ischemia plus 10 minutes of reperfusion. Cold crystalloid cardioplegia was used to cause the hearts to arrest. This was followed by 45 minutes of global ischemia and 40 minutes of reperfusion. The change of myocardial hemodynamics, myocardial enzyme in the coronary effluent and myocardial energetic metabolism were determined. Results CF?HR?LVDP and ±dp/dt recovery were expressed as percent of their baseline values at poet reperfusion 5,10,20,30,40 minutes respectively. The recovery of the four indexes had a significant improvement in the IPC group CK MB leakage was decreased. The myocardial levels of ATP in preconditioned group at the end of the reperfusion were significantly preserved. Conclusions When IPC is used together with cardioplegia, it can still have a protective effect on the immature rabbit hearts suffered from global I/R injury. The findings may be beneficial for the combination of IPC and traditional myocardium protection measure in clinic such as hyperkalemic cardioplegia.

关 键 词：缺血预处理 心脏缺血再灌注损伤 心肌保护 未成熟 高钾停博液 血流动力学 冠脉流出液 心肌酶 心肌能量 

分 类 号：R614[医药卫生—麻醉学]