偏酸性含血停搏液终末控制性再灌注对未成熟心肌的保护作用  

Myocardial protection on immature myocardium:Effects of transient controlled reperfusion with warm acidic blood

作　　者：李欣[1] 高尚志[1] 

机构地区：[1]武汉大学人民医院胸心外科

出　　处：《中华实验外科杂志》2003年第10期912-914,共3页Chinese Journal of Experimental Surgery

摘　　要：目的　研究终末控制性再灌注含血停搏液 pH值与时间的关系 ,探讨对未成熟心肌保护的临床意义。方法　 3～ 4周龄健康长耳白兔 ,按含血停搏液终末控制性再灌 pH值 (6.6、7.0、7.4和 7.8)和再灌时程 (1、3、5和 7min)组合随机分为 16组 ,每组 10只 ,建立Langendorff离体心脏灌注模型。运用温血停搏液诱导停搏 ,低温保护 ,终末温血停搏液控制性再灌注技术。观察指标 :血流动力学指标 ;心肌肌酸激酶 (CK)漏出率 ;心肌细胞内Na+ 、Ca2 + 含量 ;心肌组织ATP含量 ;心肌超微结构。结果　轻度偏酸 (pH 7.0 )含血停搏液终末再灌注 3min各指标优于其余各组。结论　对于未成熟心肌 ,采用偏酸性含血停搏液终末控制性再灌的适宜 pH值为 7.0 ,时程为终末再灌开始 3min以内。过度偏酸或偏酸性再灌注时间过长均对未成熟心肌保护产生不利影响。Objective To investigate the effect of warm acidic blood controlled reperfusion in terms of the degree of acidity and duration on immature myocardium.Methods Isolated working rabbit heart model was used.160 rabbits (aged 14 21 days) were divided into 16 groups ( n =10) according to the pH values (6.6,7.0,7.4 and 7.8 by adding HCl) and the duration (1,3,5 and 7 min) of warm blood when used in controlled reperfusion.Every heart underwent 30 min normothemic global ischemia after warm blood cardioplegia induced arrest,and got warm blood controlled reperfusion at the end.Such index,including the recovery of hemodynamics,CK leakage,myocardial cell Na + and Ca 2+ content,ATP and ultrastructure were tested.Results Controlled reperfusion less than 3 min with a mildly acidic warm blood (pH 7.0) yielded best recovery.Conclusion The effects of reperfusion with warm acidic blood on the immature myocardium were influenced by degree and duration with biphasic response characteristics.

关 键 词：偏酸性含血停搏液 终末控制性再灌注 未成熟心肌 心肌保护 临床意义 PH值 

分 类 号：R654.2[医药卫生—外科学]