【摘要】 目的观察体外循环下罗格列酮对犬心肌能量代谢的影响。方法健康杂种犬18只,随机分为3组。组1和组2分别为主动脉阻断30 min及120 min;组3主动脉阻断120min并将罗格列酮加入心脏停搏液中。标本在转前、开放主动脉后15、45、75min时采集,比较血浆葡萄糖、胰岛素、乳酸和游离脂肪酸浓度及心肌葡萄糖净摄取量、胰岛素抵抗指数的变化。结果再灌注后血浆葡萄糖、胰岛素及胰岛素抵抗指数较转前明显增高,心肌对葡萄糖利用严重障碍,再灌注后血浆乳酸和游离脂肪酸浓度明显增高。与组2比较,组3血糖及胰岛素浓度增高程度明显减轻,血浆乳酸及游离脂肪酸浓度增高程度明显减小,心肌葡萄糖利用率明显增加(<0.05)。结论罗格列酮能够降低体外循环期间血浆乳酸及游离脂肪酸浓度,改善心肌能量代谢,减轻心肌缺血再灌注损伤。更多还原

【Abstract】 Objective To observe the intenvention of rosiglitazone against Cardiac energy metabolism in myocardial insulin resistance(IR) during cardiopulmonary bypass(CPB) in dogs.Methods Dogs were randomly assigned to three groups irrespective of gender.Group 1 and Group 2 were received aortic cross-clamping for 30 min and 120 min respectively.Group 3 was received aortic cross-clamping for 120 minutes with rosiglitazone(1 mg/kg) in the cardioplegic solution.The plasma concentrations of insulin,glucose,lactic acid and free fatty acids were measured at pre-bypass(control),and aortic cross-clamp off(ischemia-reperfusion) at 15,45,and 75 min.Results After myocardial ischemia-reperfusion,the plasma Concentrations of glucose,insulin and insulin resistant index(IRI) were significantly increased and reached their peak levels after being reperfused 15 minutes later(P <0.05),Meanwhile there was severe dysfunction in myocardial glucose uptaking and utilization.Comparied with group 2,these changes were relatively mild and the utilization of glucose was remarkably increased in dogs treated with rosiglitazone(group 3)(P <0.05),After ischemia reperfused,the plasma lactic acid and free fatty acids increased obviously,the longer ischemia,the higher it could be,and no decline.Comparied with group 2,group 3 increases less severely(P <0.05).Conclusion The increased plasma lactic acid and free fatty acids is positively correlated with the duration of ischemia.Adding rosiglitazone into the cardioplegic solution during CPB can reduce plasma lactic acid and free fatty acid concentration,increase the utilization rate of myocardial glucose,improve cardiac energy metabolism,and reduce myocardial IR and ischemia-reperfusion injury.更多还原