Na^+/H^+交换、Na^+/K^+/2Cl^-转运体抑制剂对缺血大鼠心脏保护作用的研究  

Myocardial protective effects of Na^+/H^+ exchange and Na^+/K^+/2Cl^- cotransporter inhibitors on isolated rat hearts

作　　者：谭松涛[1] 杨双强[2] 杨朝坤[1] 

机构地区：[1]广东武警总医院外一科,广州510507 [2]重庆医科大学第一附属医院心胸外科,重庆40001

出　　处：《中国心血管杂志》2003年第5期320-323,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：目的　研究 Na+ /H+ 交换抑制剂阿米洛利 (Am iloride)、Na+ /K+ /2 Cl- 协同转运抑制剂呋塞米 (Furosemide)对长时间低温保存下离体大鼠心脏的保护作用。方法　建立 L angendorff及工作心脏灌注模型。实验组用 St.Thomas- 2 (STH- 2 )液 +阿米洛利 +呋塞米停搏并保存其中 ,对照组只用 STH - 2停搏、保存。置 7℃环境 5 h后恢复灌流。观察血流动力学、心肌酶学及超微结构的变化。结果　实验组冠状动脉流量 (CAF)、左心室收缩压 (L VSP)、左心室压力变化速率 (± dp/dt)的恢复率均优于对照组 (P<0 .0 1) ;肌酸磷酸激酶 (CPK)、乳酸脱氢酶 (L DH)漏出量明显少于对照组 (P<0 .0 5 ) ;心肌组织中 Na+ - K+ - ATP酶、Ca2 + - ATP酶和 Ca2 + - Mg2 + - ATP酶活力均显著高于对照组 (P<0 .0 1) ;实验组的心肌细胞超微结构得到较好的保护。结论　 Na+ /H+ 交换、Na+ /K+ /2 Cl-Objective To investigate the protective effects of Na +/H + exchange inhibitor (Amiloride) and Na +/H +/2Cl - cotransporter inhibitor (Furosemide) on long term preserved rat hearts.Methods Isolated rat hearts ( n =10/group) were perfused on a Langendorff apparatus.Hearts in experimental group(Group E) were arrested by St.Thomas solution II (STH 2)Plus drugs (Amiloride and Furosemide),control group were arrested only by STH 2.Then these hearts were preserved in the corresponding cardioplegia solution at 7℃.After 5 hours of storage,hearts were reperfused.Results There were no significant differences in preischemic indexes between two groups.After reperfusion,CAF,LVSP and ±dp/dt showed markedly better recovery in Group E( P <0.01).The leakages of CPK,LDH in Group E were lower than those in control group ( P <0.05),the activities of Na + K + ATPase,Ca 2+ ATPase and Ca 2+ Mg 2+ ATPase in Group E were significantly higher than those in control group( P <0.01).Myocardial ultrastructures of Group E were better protected.Conclusion Amiloride and Furosemide can significantly enhance cardiac protection for long term heart preservation.

关 键 词：阿米洛利 呋塞米 NA^+/H^+交换 Na^+/K^+/2C1^-协同转运 心肌缺血 再灌注损伤 

分 类 号：R654.2[医药卫生—外科学]