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不同心肌保护液对供心移植保护作用的对比研究

The Protection Effects of Different Cardioplegiae on Warm Ischemic Myocardium

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【作者】 池一凡许慧侯文明孙忠东牛兆倬杨铁南

【Author】 CHI Yi-fan,XU Hui,HOU Wen-ming,SUN Zhong-dong ,NIU Zhao-zuo,Yang Tie-nan (1. Qingdao Municipal Hospital,Medical College of Qingdao University,Shandong Qingdao 266012,Department of Anesthesia,the Affiliated Hospital of Qingdao University Medical College,Shandong Qingdao 266003 China)

【机构】 青岛大学医学院附属青岛市立医院心外科青岛大学医学院附属医院麻醉科青岛大学医学院附属青岛市立医院心外科 山东青岛266012山东青岛266003山东青岛266012山东青岛266012

【摘要】 目的 研究改良心肌保护液对短暂常温热缺血供心移植后的保护作用。方法  18只家猪随机分为 3组 ,对照组 (C组 ) :不缺血下供心低温灌注St.Thomas液后切取 ,4℃保存 4h后行原位心脏移植 ;热缺血组 (W组 ) :供心灌注低温St.Thomas保护液前常温缺血 5min ,4℃保存 4h后行原位心脏移植 ;改良心肌保护液组 (E组 ) :供心常温缺血 5min后用改良保护液灌注和保存 ,4℃保存 4h后行原位心脏移植。以心脏排出量 (CO)、心肌含水率、丙二醛(MDA)和ATP含量、肌钙蛋白I(cTnI)和心脏超微结构作为观察指标。结果 心肌含水率、MDA含量和cTnI含量E组明显低于W组 (P <0 .0 5 ) ;CO和ATP含量E组明显高于W组 (P <0 .0 5 ) ;E组与C组相比无显著差异 (P>0 .0 5 ) ;超微结构 ,E组损伤较W组明显减轻。结论 改良心肌保护液可有效改善供心因短暂常温热缺血而造成的结构和功能损害。

【Abstract】 OBJECTIVE To evaluate the effects of modified cold cardioplegia on warm ischemic myocardium. METHODS 18 pigs were randomly divided into 3 groups.Control group (C),the donor hearts were arrested and stored for 4 hours preserved by St.Thmoas solution; warm ischemia group (W),the donor hearts had 5 min warm ischemia followed arrested and preserved in 4℃ St.Thomas solution; modified cold cardioplegia group(E),the donor hearts had 5 min warm ischemia followed arrested and were preserved with 4℃ modified cold cardioplegia,and othortopic heart transplantation models were established,respectively.RESULTS Myocardial water content,MDA content,in E goup are lower than W group. CO and ATP content in E goup are higher than W group. The myocardial ultrastructure injury is severe in E and C group than W group.CONCLUSION Modified cold cardioplegia gives more protections for warm ischemia donor heart in structure and function.

【基金】 青岛市科委资助项目 (2 0 0 1 KNS 2E 5 1)
  • 【文献出处】 中国体外循环杂志 ,Chinese Journal of Extracorporeal Circulation , 编辑部邮箱 ,2004年02期
  • 【分类号】R654.1
  • 【下载频次】61
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