含匹那地尔的超极化停搏液对大鼠心肌的保护作用(PDF)
《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]
- 期数:
- 2003年第3期
- 页码:
- 212-214,217
- 栏目:
- 实验研究
- 出版日期:
- 2003-05-01
文章信息/Info
- Title:
- Protective effect of hyperpolarized cardioplegia with pinacidil on rat cardiac muscles
- Author(s):
- WANG Wen-dong; ZHANG Kai-lun; HU Zhi-wei
- Department of Cardiovascular Surgery of Union Hospital,Tong ji Medical College of Hua zhong University of Science and Technology,Wu han,Hu bei430022,China
- 分类号:
- R541.4;Q463
- DOI:
- -
- 文献标识码:
- A
- 摘要:
- 目的:探讨含匹那地尔的冷超极化停搏液是否能延长心肌缺血的安全时限。方法:在改良Langendorff离体大鼠工作心模型上进行低温缺血/再灌注实验,以4℃除极化停搏液St.Thomas液为对照组,4℃含匹那地尔的超极化停搏液为实验组,根据停搏液种类和停搏时间不同,把40只大鼠随机分为4组,每组10只:S1,S2为对照组,停搏时间分别为1h,2h;P1,P2为实验组,停搏时间分别为1h,2h。观察缺血前及再灌注转为工作心后心功能指标,缺血前及再灌注后心肌酶值变化,心肌ATP含量,心肌超微结构改变及心肌含水率。结果:低温缺血/再灌注后实验组P1,P2在心排出量恢复率,冠脉流量恢复率,左室最大收缩压力变化速度及左室峰压恢复率均优于对照组S1,S2(P<0.05);灌注停搏液后心肌机械活动和电活动的消失时间,实验组明显长于对照组(P<0.01);在保存心 肌ATP含量及乳酸脱氢酶(LDH)方面,P1优于S1(P<0.05),而P2与S2相当。再灌注后磷酸肌酸激酶同工酶(CK-MB)漏出量及心肌含水率,实验组P1,P2与对照组S1,S2相比无显著差异;在心肌超微结构改变方面,P1与S1,P2与S2相似;再灌注时P2室颤发生率为20%。结论:匹那地尔可作为心肌保护成分。含Pinacidil的冷超极化停搏液可使心肌停搏的安全时限延至2h。其心肌保护作用优于传统高钾冷晶体停搏液。
- Abstract:
- AIM:To test the hypothesis that myocardial protection with Pinacidil,one of potassium channel openers(PCOs), is feasible during prolonged periods of hypothermic cardioplegic arrest.METHODS: Using a modified isolated rat working heart model,40 hearts were divided randomly in to 4 groups,which underwent 1 h or 2 h of global hypothermic ischemia followed by 60 min of reperfusion.Two different cardioplegic solutions were administered intermittently:①S1(n=10):4℃ St.Thomas'solution as control group,with the arrest time of 1 h;②P1(n=10):4℃ Krebs-Henselleit solution with Pinacidil(50μmol/L),with the arrest time of 1 h;③S2:4℃ St.Thomas'solution as control group,with the arrest time of 2 h;④P2:4℃ Krebs-Henselleit solution with Pinacidil(50μmol/L),with the arresting time of 2 h. Preischemic and postischemic myocardial functions were assessed by the percentages of cardiac output(CO),coronary flow(CF),left ventricle end-systolic pressure(LVSP),±dp/dtmax,the level of creatine kinase(CK-MB), dehydrogenase (LDH) in coronary sirnus effluent, and by ATP,water content of myocardium and myocardial ultrastructural changes. RESULTS: The recovery percentages of CO, CF, LVSP,+dp/dt were significantly higher in groups P1 and P2 than in groups S1 and S2 (P<0.05). The arresting periods of electric and mechanic activities were longer in groups P1 and P2 than in groups S1 and S2 (P<0.01). ATP and LDH was better in group P1 than in group S1. The incidence of ventricular fibrillation on reperfusion in group P2 was 20%.CONCLUSION: Pinacidil is an effective cardioplegic agent. Hyperpolarized cardioplegic with Pinacidil can arrest heart for over 2 h and is better than traditional St.Thomas'solution in myocardial protection.
参考文献/References
[1] Lawton JS,Harrington GC,Allen CT,et al.Myocardial protection with Pinacidil cardioplegia in the blood-perfused heart [J]. Ann Thorac Surg,1996,61:1680-1888.
[2]Noma A.ATP-regulated K+ channels in cardiac muscle[J].Nature,1983,305:147-148.
[3] Thuringer D, Escande D.Apparent competition between ATP and the potassium channelopener, RP 49356, on ATP sensitive K+ channels of cardiac myocytes [J]. Mol Phamacol,1990,36:897-902.
[4] He GW, Yang CQ. Superiority of hyperpolarizing to depolarizing cardioplegia in protection of coronary endothelial function [J]. J Thorac Cardiovasc Surg,1997,114:643-650
[5] Lawton J, Sepic J,Allen C,et al.Myocardial protection with potassium channel openers is as effective as St.Thomas' solution in the rabbit heart [J]. Ann Thorac Surg,1996,62:31-39.
[6] Mauney MC, Kron IL. The physiologic basis of warm cardioplegia [J]. Ann Thorac Surg, 1995, 60:819-823.
[7] Maskal SL,Fields CE, Cohen NM, et al.Persistent electrical activity during hyperpolarized cardiac arrest does not affect post ischemic myocardial recovery [J]. Surg Forum,1995,46:222-224.
备注/Memo
- 备注/Memo:
- 收稿日期：2002-3-19.
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