应用改良的特殊染色方法观察缺血预适应对心肌再灌注早期病理改变的影响  

Effect of ischemic preconditioning on myocardial pathological changes of felines during ischemia and reperfusion injury:observation by modified pathologic staining

作　　者：何斌[1] 王志农[1] 刘延玲[1] 曾志勇[1] 张波[1] 徐志云[1] 黄盛东[1] 张宝仁[1] 

机构地区：[1]第二军医大学长海医院胸心外科,解放军胸心外科研究所上海200433

出　　处：《第二军医大学学报》2004年第4期370-373,共4页Academic Journal of Second Military Medical University

基　　金：上海市曙光计划资助项目 ( 0 2 SG3 0 ) ;上海市青年科技启明星计划资助项目 ( 0 0 QB14 0 5 3 )

摘　　要：目的 :应用两种改良的特殊染色法研究体外循环 (CPB)中心肌缺血再灌注早期病理形态特征的改变。方法 :建立猫CPB模型并随机分成 3组 :对照组 (n=5 )仅作单纯并行 CPB转流 ,不阻断升主动脉 (ACC) ;缺血再灌注组 (IR组 ,n=5 )于CPB开始 4 5 min后 ACC6 0 min,开放主动脉使心脏恢复再灌注 ;IPC组 (n=5 )于 ACC前进行 IPC(ACC5 min后开放 1 0min,并重复 3次 ) ,余同 IR组。分别应用改良的碱性复红 -苦味酸特殊染色法 (HBFP)和改良的 Gonori变色酸亮绿特殊染色法(GCA)观察各组再灌注早期心肌变性变化 ,并结合透射电镜直接观察各组再灌注早期心肌超微结构的损伤情况。 结果 :H- E染色难以识别 IR组和 IPC组之间损伤程度差异。再灌注早期 ,对照组 HBFP特殊染色及 GCA特殊染色均呈阴性着色 ,IR组呈弥漫性阳性着色 ,而 IPC组呈局灶性或小片状阳性着色 ,两组间差异显著 (P<0 .0 5 ) ;而且心肌组织染色深浅与心肌超微结构损伤的程度相一致。结论 :应用改良的 HBFP和 GCA特殊染色法均能显示心肌再灌注早期病理改变 ,敏感性较高 ,特异性较好 ;结果提示 IPC有助于心肌再灌注早期缺血、缺氧的改善 。Objective:To observe the myocardial pathological changes during the early period of heart reperfusion under cardiopulmonary bypass(CPB) by 2 modified pathologic staining techniques. Methods:Fifteen felines were randomized into 3 groups: control group( n =5),in which CPB was conducted without aortic cross clamping(ACC);IR group( n =5),with 60 min ACC followed by reperfusion,and cardioplegia was used during period of ACC;IPC group( n =5),with protocol similar to that of IR group except for three cycle 15 min IPC applied before ACC. The changes of myocardium were evaluated by the modified haematoxylin fuchsin basic picric acid(HBFP) and the modified Gonori chromotropic acid(GCA) staining respectively. The ultrastructural changes of the myocardium were observed simultaneously under the electron microscopy. Results:Negative HBFP and GCA staining were found in myocardium of control group,while diffused HBFP and GCA positive staining were observed in myocardium of IR group. However,only focal positive staining appeared in that of IPC group. There were significant differences between IR group and IPC group in positive straning density( P <0.05). Moreover,the positive degree of the 2 pathologic staining was paralleled with the myocardial ultrastructural changes. Conclusion:HBFP and GCA staining can be used to observe the myocardial pathologic changes at the early period of myocardial reperfusion sensitively and specifically. IPC seems to attenuate the anoxemic and denaturated changes of the myocardium from ischemia and reperfusion injury during CPB in feline.

关 键 词：特殊染色方法 观察 缺血预适应 心肌再灌注 病理 心肌细胞 体外循环 

分 类 号：R654.1[医药卫生—外科学]