【摘要】 目的探讨HOE-642联合改良K/Mg冷血心麻液提高犬供心的保存效果的作用。方法雄性成年杂种家犬32只,随机分为整合组和常规组(每组16只,供、受者各8只)。(1)整合组：供心保护采用HOE-642联合改良K/Mg冷血心麻液的“整合策略”；(2)常规组：供心保护采用临床上常规方法。所有动物的供心均冷浸浴保存4h,心脏移植用原位标准法。记录不同时段的心功能指标；实验结束后观察心肌超微结构并测定心肌含水量。结果每组各1例主动脉开放后因主动脉吻合口漏血,失血性休克死亡,剔除出实验；其余动物均成功脱离体外循环。整合组的移植心脏左心室收缩功能和舒张功能恢复指标显著优于常规组(P＜0．05)；整合组心肌组织含水量显著小于常规组(P＜0．05)；整合组心肌细胞亚细胞结构的保存亦优于常规组。结论临床常规方法和HOE-642联合改良K/Mg冷血心麻液的“整合策略”,均可安全冷保存供心4h,但后者能进一步减轻心肌水肿、维持心肌细胞结构完整、促进缺血/再灌注损伤后心功能的恢复,具有更佳的心肌保护效果。更多还原

【Abstract】 Objective To investigate the myocardial protective effects of“integrated strategy”with HOE-642 plus modified K/Mg on canine heart grafts.Methods Sixteen donors-recipient pairs of adult canines were divided into the“integrated strategy”group,i.e.,donor hearts were protected with HOE-642 plus K/Mg(IS,n=8)and the routine method(RM,n=8)group.Both groups un- derwent hypothermia stored for 4 h,followed by orthotopic transplantation.Cardiac heamodynamics was measured and myocardial ultrastructure and myocardial water content were evaluated.Results One of 8 animal died of aortic anastomoses leakage in each group,and the rest could wean from car- diopulmonary bypass successfully.Preservation of left ventricular contractility,as well as left ventric- ular compliance was significantly better in the IS group than in the RM group(P＜0.05),also,per- centage of myocardial water content was significantly lower in the IS group than in the RM group(P＜0.05).Myocardial ultrastructures were not damaged significantly in both groups,however,better myocardial preservation were seen in the IS group.Conclusion Both the clinically used“routine meth- od”and“integrated strategy”might provide safe donor heart preservation for 4 h,but the later scheme conferred more optimal effects with alleviating the myocardial swelling,preserving myocardial ultra- structure integrity and enhancing postischemic-reperfusion cardiac functional recovery.更多还原