【摘要】 目的　研究体外循环围术期血浆降钙素基因相关肽 (CGRP)的变化规律及外源性CGRP对体外循环全心缺血 -再灌注损伤后心功能恢复的影响。方法　建立猪体外循环心肌缺血 -再灌注模型 ,应用放射免疫法分别于体外循环前后 6个时间点测定冠状静脉血浆CGRP含量 ,并在用药组于主动脉阻断时和开放前应用外源性CGRP ,在心肌再灌注前后不同时间点观测心率、血压、左室收缩末压和舒张末压 ,以及冠状静脉血浆丙二醛含量、超氧化物歧化酶活性的变化。结果　体外循环心肌再灌注后早期冠状静脉血浆CGRP水平显著升高 ,随再灌注时间的延长逐渐上升 ,持续至后 12 0min。应用外源性CGRP后发现 ,用药组在体外循环心肌再灌注后心律失常的发生率较低 ,再灌注后各时间点的心率、血压、左室收缩末压、舒张末压等均较对照组改善 ,冠状静脉血浆丙二醛含量较低、超氧化物歧化酶活性较高。结论　内源性CGRP水平在猪体外循环心肌缺血 -再灌注后持续升高具有代偿性的心肌保护作用 ;外源性CGRP作为心肌麻痹液的组成部分 ,可显著改善猪体外循环心肌再灌注后的心功能 ,因而具有心肌保护作用更多还原

【Abstract】 Purpose To observe the changes of plasma calcitonin gene related peptide (CGRP) concentration in perioperative period associated with cardiopulmonary bypass (CPB) and to study the myocardial protective effects of exogenous CGRP on global ischemia reperfusion heart associated with CPB. Methods An in vivo porcine model of CPB was established.Twenty pigs,10 controls and 10 CGRP used animals (CGRP group),were performed a median sternotomy followed by a standard CPB.All the hearts were arrested for 45 minutes.In the CGRP group,1 μg/kg CGRP was added into the the cardioplegia,and CGRP of the same dosage was reperfused into the aortic root just before the aortic cross clamp was removed.Plasma concentration of CGRP from coronary sinus blood was measured by radioimmunoassay in the control group on six consecutive points of time,which were before CPB,before aortic cross clamped,5,30,60 and 120 minutes after reperfusion.In both groups,heart rate,peripheral blood pressure,left ventricular end systolic and diastolic pressure (LVESP and LVEDP),plasma malodialdehyde (MDA) concentration and super oxide dismutase (SOD) activity from coronary sinus blood were determined simultaneously on these points of time. Results Plasma CGRP level during CPB before heart arrest was of no statistical difference from that before CPB,while markedly increased when the heart was reperfused.It continued to go up and remained a high level 120 minutes postoperatively.No cardiac arrhythmias during reperfusion were found in the CGRP group while arrhythmias of 3 cases were presented in the control group.Heart rate was slower and blood pressure was higher,LVESP was higher and LVEDP was lower respectively in the CGRP group on different points of time after reperfusion compared to those in the control group.Low concentration of plasma MDA and higher activity of plasma SOD in the CGRP group were also existed on every point of time during reperfusion period in the CGRP group. Conclusions The elevated level of plasma CGRP has a protective effect on the reperfusion heart associated with CPB.Exogenous CGPR as a component of cardioplegia improves cardiac function after reperfusion associated with CPB.Thus CGRP has a significant protective effect on the reperfusion heart associated with CPB in pig.更多还原