离体兔心冠状静脉窦逆灌心肌保护方法的比较研究-外科学(心胸外科)专业论文.docxVIP

离体兔心冠状静脉窦逆灌心肌保护 离体兔心冠状静脉窦逆灌心肌保护 方法的比较研究 摘 要 目的：采用离体兔心逆灌模型，比较研究常温氧合血逆灌心脏不停跳、 温血心脏麻痹液逆灌、冷血心脏麻痹液逆灌、冷晶体心脏麻痹液逆灌四种 方法的心肌保护效果。 ／方法：离体兔心按逆灌方法不同随机分为四组：A组，冷晶体心脏麻痹 液逆灌；B组，冷血心脏麻痹液逆灌；c组，温血心脏麻痹液逆灌；D组， 常温氧合血逆灌心脏不停跳。心脏逆灌60rain后转为Langendorff-Neely顺灌 左心做功模型，心脏做功60min。测定心功能、心肌酶漏出、心肌乳酸含量、 心肌细胞内游离钙、心肌细胞膜ATP酶活性和膜脂流动性，并进行统计学分 析。 结果：主要结果如下： (1)逆灌后恢复顺灌左心做功，D组心功能、心肌细胞膜ATP酶活性和 膜脂流动性恢复明显优于A、B和C组(p0．oi)，B和C组优于A组(p0．01)。 (2)逆灌后恢复顺灌左心做功，D组心肌酶CK、LDH漏出、心肌乳酸 和膜MDA含量、心肌细胞内钙离子浓度明显低于A、B和C组(pO．01)， A组最差。、L 结论：建立了离体兔心常温氧合血逆灌心脏不停跳模型。经冠状静脉 窦逆灌是有效的心肌保护方法。本实验结果表明：常温氧合血逆灌心脏不 停跳的心肌保护效果优于冷晶体心脏麻痹液逆灌、冷血心脏麻痹液逆灌和 温血心脏麻痹液逆灌。其机制可能与常温氧合血逆灌心脏不停跳减少自由 基的产生，减轻细胞内钙超载，较好地维持细胞膜脂的流动性有关。 关键词：冠状静脉窦逆灌 不停眺(心脏麻痹液，．缺血再灌注损伤 膜脂流动性，离体兔心模型 Comparative Comparative Study of Myocardial Protective Effects of Retrograde Coronary Sinus Perfusion Methods on Isolated Rabbit Hearts Abstract Objective：The myocardial protective effects of retrograde normothermic blood perfused bering heart were evaluated on all isolated rabbit heart model， compared with retrograde perfusion with cold crystalloid cardioplegia，cold blood cardioplegia or warm blood cardioplegia． Methods：Isolated rabbit hearts were randomly subjcoted into four groups group A received retrograde coronary sinus perfusion with cold erystalloid cardioplegia，group B with cold blood cardioplegia，group C with warm blood cardioplegia，and group D were maintained heart beating by retrograde perfusion with normothermic oxygenated blood．After 60min retrograde perfusion，the hearts were switched on Langendorff-Neely antegrade perfused working heart model for another 60min．The heart function，myocardial enzyme leak，myocardial lactate content，intramyocyte free calcium， myocardial membrane ATPase and fluidity were measured and analysed statisticaly． Results：The main results are as followings： 1．After retrograde coronary sinus perfusion，recovery of cardiac function， activity of ATPase and fluidity of the myocardial membrane in group D was superior to those of group A，B and C(pO．O 1)．Recovery of group