【摘要】 目的探讨去白细胞血再灌注液对体外循环(CPB)犬心肌缺血再灌注损伤的影响及其机制。方法成年健康犬12条,根据再灌注液成分不同随机分为对照组(C组)和去白细胞血组(D组),每组6条。两组动物经麻醉和开胸后,建立CPB心肌缺血再灌注模型,阻断升主动脉60 min。于阻断40min时,自主动脉根部以2 ml·min-1·kg-1灌入常温晶体液或去白细胞血,持续20 min。分别于阻断前、阻断后30min及60min和开放后30min及60min取静脉血,检测血浆TNF-α、IL-1β、IL-6、IL-8浓度。并于阻断前、阻断后60 min和开放后60 min分别取心肌组织检测髓过氧化物酶(MPO)活性。结果与阻断前比较,阻断后各时点两组TNF-α、IL-1β和IL-8血浆浓度均升高,IL-6血浆浓度在开放后各时点升高(P<0．05);D组开放升主动脉后各时点TNF-α、IL-1β、IL-6和IL-8血浆浓度低于C组(P< 0．01);D组阻断后60 min和开放后60 min MPO活性低于C组(P<0．01)。结论去白细胞血再灌注液能减轻体外循环犬的心肌缺血再灌注损伤,抑制促炎性细胞因子可能是其作用机制之一。更多还原

【Abstract】 Objective To evaluate the protective effects of leukocyte-depleted blood reperfusion on myocardium against ischemia-reperiusion (I/R) injury during cardiopulmonary bypass (CPB).Methods Twelve healthy adult mongrel dogs of either sex weighing 12-15 kg were randomly divided into 2 groups according to reperfusion solution used: control group (group C, n = 6) and leukocyte-depleted blood group (group D, n = 6) . The dogs were anesthetized and mechanically ventilated after tracheal intubation.Femoral artery and vein were cannulated for MAP and CVP monitoring.Lactated Ringer’s solution and HES (1:1) were used as priming solution. Bubble oxygenator was used. Chest was opened and CPB was started after heparinization. The aorta was clamped for 60 min during CPB. At 40 min of myocardial ischemia leukocyte-depleted blood or Ringer’s solution was continuously perfused at 2 ml·kg·-1·min-1 through aortic root for 20 min. Venous blood samples were taken at 5 min after CPB was started, 30 and 60 min after aortic clamping and 30 and 60 min after aortic declamping for determination of serum proinflammatory cytokines (TNF-α, IL-1β,IL-6 and IL-8). Myocardial specimens were taken for determination of myeloperoxidase (MPO) activity before and 60 min after aortic clamping and 60 min after aortic declamping. Results The plasma concentrations of proinflammatory cytokines (TNF-α, IL-1β,IL-6 and IL-8) were significantly increased after aortic declamping as compared to the baseline values before aortic clamping in both groups and were significantly lower in group D than in group C (P< 0.01) . Myocardial MPO activity was significantly lower at 60 min after aortic clamping and 60 min after aortic declamping in group D than in group C (P < 0.01). Conclusion Reperfusion of myocardium with leukocyte-depleted blood can protect myocardium from I/R injury during CPB probably through inhibition proinflammatory cytokines.更多还原