吡那地尔超极化心脏停搏液对再灌注后细胞因子及心脏功能的影响  

The effect of pinacidil hyperpolarized cardioplegic solution on cytokine and cardiac function after reperfusion

作　　者：刘斌[1] 李坚[1] 王儒蓉[1] 郭应强[2] 隋东虎[2] 

机构地区：[1]四川大学华西医院麻醉科,成都610041 [2]四川大学华西医院胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2003年第4期273-275,共3页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省卫生厅科研基金资助项目 ( 0 0 0 0 17)~~

摘　　要：目的　观察犬体外循环 (CPB)再灌注后吡那地尔超极化心脏停搏液与传统高钾心脏停搏液对肿瘤坏死因子α(TNF-α)、白细胞介素 6 (IL - 6 )和心脏功能的影响。　方法　 12只雄性杂种狼犬随机分为两组 ,对照组 (n=6 ) :主动脉阻断时用 4℃ St.Thomas 号心脏停搏液 (K+ 2 0 mmol/ L) ,每 30分钟灌注 1次 ;实验组 (n=6 ) :用 4℃含吡那地尔 5 0μmol/ L的 St.Thom as 号心脏停搏液 (K+ 5 mm ol/ L ) ,每 5 0分钟灌注 1次。两组犬主动脉均阻断 15 0分钟。在转流前和主动脉开放后 180分钟时测定 TNF- α和 IL- 6的含量 ,于转流前、主动脉开放后 30、6 0、12 0和 180分钟时监测血流动力学指标的变化。　结果　主动脉开放后 180分钟 ,两组 TNF- α和 IL- 6与转流前比较均明显升高 (P<0 .0 1) ,但两组间比较差别无显著性意义。主动脉开放后 12 0分钟和 180分钟 ,两组平均动脉压 (MAP)、心脏指数(CI)、每搏指数 (SI)、左心室每搏作功指数 (L VSWI)与转流前比较均明显降低 (P<0 .0 5 ) ,但两组间差别无显著性意义。　结论　与传统高钾心脏停搏液比较 ,吡那地尔超极化心脏停搏液无明显的减轻炎性反应作用 ,其改善心功能的作用也并不优于传统的高钾心脏停搏液。Objective To comparatively evaluate the effect of pinacidil hyperpolarized cardioplegic solution versus hyperkalemic cardioplegic solution on tumor necrosis factor-α(TNF-α) , interleukin 6 (IL-6) and cardiac function after reperfusion. Methods Twelve male mongrel wolfhounds undergoing cardiopulmonary bypass (CPB) were randomly divided into two groups, control group (n=6): perfused with 4℃ St. Thomas Ⅱ solution (K+ 20 mmol/L) every 30 min, experimental group (n=6): perfused with 4℃ St. Thomas Ⅱ solution containing pinacidil, 50 μmol/L (K+ 5 mmol/L) every 50 min during aortic clamping. The duration of aortic cross-clamping was 150 min in both groups. TNF-α and IL-6 were detected at pre-CPB and 180 min after reperfusion. Hemodynamic parameters were measured at pre-CPB, 30min, 60min, 120min and 180min after reperfusion, respectively. Results Compared with pre-CPB, the plasma values of TNF-α and IL-6 increased in two groups at 180 min after reperfusion (P<0.01), but there was no differences between two groups (P>0.05). Mean arterial pressure (MAP), cardiac index (CI), stroke index (SI) and left ventricular stroke volume work index (LVSWI) decreased at 120 min and 180 min after reperfusion in two groups (P<0.05), but there was no differences between two groups (P>0.05). Conclusion Compared with traditional hyperkalemic cardioplegic solution, pinacidil hyperpolarized cardioplegic solution could not alleviate the inflammatory response and could not improve the cardiac function after reperfusion.

关 键 词：吡那地尔 心脏停搏液 再灌注 细胞因子 心脏功能 体外循环 血流动力学 

分 类 号：R96[医药卫生—药理学]