阿片预处理对兔供心保存的保护作用  

Protective Effects of Opioid Preconditioning on Rabbits Donor Heart Preservation

作　　者：方友平[1] 陈广明[2] 吴延虎[2] 秦建伟[2] 王永功[2] 

机构地区：[1]南京医科大学附属淮安第一医院心胸外科,江苏淮安223300 [2]南京医科大学第一附属医院心胸外科

出　　处：《中国医师杂志》2003年第9期1173-1175,共3页Journal of Chinese Physician

摘　　要：目的　观察δ -阿片受体激动剂D -丙 2 ,D -亮 5 -脑啡肽 (DADLE)预处理对兔供心的保存效果及保护机制。方法　2 4只成年家兔随机分为 4组 ,每组 6只 ,2组为供体组 (A组、B组 ) ,B组供心在获取前给予DADLE预处理 ,A组予等量生理盐水作为对照 ,余 2组为受体组 ,接受移植手术。供心原位冷心脏停搏液灌注 ,切取后 4℃Krebs -Henseleit(K -H)保存液保存 4h。腹腔异位心脏移植术后 ,观察供心功能恢复情况。 2h后测心肌组织中活性氧含量及钠 -钾ATP酶活性 ,透射电子显微镜观察心肌超微结构改变。结果　B组心功能恢复较好 ( P <0 0 5 ) ;钠 -钾ATP酶活性好于A组 ( P <0 0 5 ) ,活性氧含量明显高于A组 ( P <0 0 0 1)。B组心肌超微结构损伤较A组轻。结论　阿片预处理结合低温对兔供心保存有明显的保护作用 ,其机制可能与其对线粒体结构保护良好及诱导自由基产生启动内源性保护机制有关。Objective To study the effects of D-Ala2-Leu5-enkephalin(DADLE) preconditioning on rabbit donor heart preservation and protective mechanism.Methods 24 rabbits were randomly divided into 4 groups. In group B, after preconditioning with DADLE(1mg·kg -1 ), the donor hearts were then arrested and preserved with Krebs-Henseleit buffer at 4℃ for 4h,and group A without conditioning as controls. Then the donor hearts were transplanted into the abdomen of recipient rabbits. Recovery situation of contraction of the donor heart was compared. The left ventricular tissues were obtained from the donor hearts after 2h of transplantation.The contents of free radicals and ATPase activity were determined and cardiac ultrastructure were observed.Results After 4h cold storage, the heart undergoing DADLE preconditioning in group B showed better recovery of left ventricular development pressure (LVDP).The activity of sodium-potassium ATPase in group B were higher than that in group A. DADLE increased free radical production 2-fold versus group A. Group B showed slighter injury in transmission electron microscopy observation than that in group A.Conclusion Our study demonstrated opioid preconditioning has protective function to rabbit heart injury caused by long term cold storage. The protective mechanism maybe related to increase of free radical content.

关 键 词：心脏保存 心脏移植 药物预处理 阿片受体 兔 

分 类 号：R541[医药卫生—心血管疾病]