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血液超极化停搏对体外循环缺血心肌保护的研究 被引量:4

Protective effect of hyperpolarized arrest with blood cardioplegic solution containing pinacidil on ischemic myocardium during cardiopulmonary bypass
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摘要 目的 评价含ATP敏感性钾通道开放剂吡那地尔的血液停搏液诱导的心脏超极化停搏在常温与低温体外循环下对缺血心肌的保护效果。方法  18只犬随机分为对照组 (A组 )、常温血液超极化组 (B组 )、低温血液超极化组 (C组 ) ,每组 6只。对照组以 4℃标准St Thomas液 (K+16mmol/L)为心脏停搏液 ,常温血液超极化组和低温血液超极化组分别以含吡那地尔 5 0 μmol/L的37℃St Thomas液 (K+ 5mmol/L ,含血比例 1:1)和含吡那地尔 5 0 μmol/L的 4℃St Thomas液 (K+5mmol/L ,含血比例 1:1)为心脏停搏液。体外循环期间 ,A组和C组温度保持在 2 6℃~ 2 8℃ ,B组温度保持在 35℃~ 37℃。三组体外循环 (CPB)期间 ,均全心缺血 6 0min ,恢复灌注 30min。对比观察阻断升主动脉前、后心肌腺苷酸 (ATP、ADP、AMP、TAN、EC)含量、心肌超微结构、脂质过氧化物丙二醛(MDA)含量以及血液动力学多项参数的变化。结果 对照组在阻断 5 0min和开放 30min ,心肌各项指标均显示有明显的缺血和再灌注损害 ;而血液超极化组损害较轻 ,特别是低温血液超极化组 ,损害最轻。结论 含吡那地尔的血液停搏液诱导的超极化停搏 ,其心肌保护效果明显优于传统的高钾去极化停搏 ;低温血液超极化停搏又优于常温血液超极化停搏。 Objective To compare the myocardial protective effect of hyperpolarized cardioplegic arrest with pinacidil against that of depolarized hyperkalemic arrest during cardiopulmonary bypass Methods Eighteen healthy mongrel dogs of both sexes weighing 10 15kg were divided into three groups of six each, according to the cardioplegic solution infused into aortic root after aortic cross clamp was applied; group A received 4℃ standard St Thomas solution (K +16mmol/L); group B 37℃ St Thomas solution (K +5mmol/L) containing pinacidil (50μmol/L) mixed with blood (the ratio was 1:1);group C 4℃St Thomas solution (K + 5mmol/L) containing pinacidil(50μmol/L) mixed with blood (1∶1) The global ischemic time was 60min followed by 30min reperfusion Myocardial tissue was taken before and 30min, 60min after aortic cross clamping and 30min after reperfusion for determination of myocardial content of adenine nucleotide and MDA and ultrastructure examination with electron microscope Hemodynamics (BP,CVP,PCWP,CO,CI and LVSW) was also measured before aortic cross clamping and 15,30min after declamping Results Significant ischemic and reperfusion damages were found in group A, while there were only mild damages in group B and C Hemodynamics recovery after aortic declamping was significantly better in group C than that in group A and B Conclusions Myocardial protective effect of hyperpolarized arrest produced by blood cardioplegic solution containing pinacidil is superior to that of traditional depolarized hyperkalemic arrest and hypothermic hyperpolarized cardioplegia is better than normothermic
出处 《中华麻醉学杂志》 CAS CSCD 北大核心 2001年第10期633-636,共4页 Chinese Journal of Anesthesiology
基金 国家自然科学基金 (3 9760 0 71)
关键词 心脏停搏 心肌再灌注损伤 哟那地尔 心脏外科手术 心肌保护 Heart arrest,induced Myocardial reperfusion injury Pinacidil
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