腺苷预处理保存供心的实验研究

Improvement of donor heart storage by adenosine preconditioning

目的 本研究探讨腺苷预处理早发效应对供心的保护效果。方法 大白兔制成离体心脏 ,以腺苷预处理后 4℃改良St .Thomas液诱导心脏停搏 ,置于该液中低温保存 4h ,再灌注 1h。观察心功能恢复率、心肌ATP、Ck -mb释放量。另设缺血预处理组和单纯改良St .Thomas液保存对照组。结果 缺血和腺苷预处理心功能恢复率 ( +dp/dtmax % )分别为 ( 74.5 6± 14 .3 8) ,( 68.3 8± 10 .47) ,均高于对照组 ( 3 2 .45± 9.46) ,差异有显著性 (P <0 .0 5 )。结论 腺苷预处理早发效应能改善供心保存效果。

Objective To study the potential improvement of donor heart storage by adenosine preconditioning.Methods Rabbit hearts were isolated and mounted on a Langendorff apparatus,perfused with filtered modified Krebs-Henseleit buffer through left atria,instrumented left ventricular function monitor system and paced ventricularly at 180 beats/min.Isolated hearts were grouped into three groups and subjected to normal perfusion or to solution supplemented with adenosine 50 μmol/L for 10 min utes followed by adenosine-free K-H or ischemic preconditioning (5 minute ischemia and 10 minute perfusion).Hearts then were arrested with 4℃ modified St.Thomas solution,and stored for 4 hours at 4℃in this solution and reperfused with K-H buffer.Left ventricular function,myocardial CK-mb leakage and tissue levels of adenosine triphosphate were measured.Results Hearts preconditioned with adenosine or ischemia had better function expressed as recovery percentage(+dp/dt max(74.56±14.38),(68.38±10.47),respectively).If compared with control group(32.45±9.46),the differences were significant(P<0.05).Conclusion This study suggests the transient preconditioning with adenosine have some beneficial effects on donor heart preservation.