尼可地尔改善心脏停搏液对心脏的保护作用

The Myocardial Preservation Effect of Nicorandil in HTK Solution and UW Solution

目的 观察在HTK液和UW液中加入尼可地尔 (Nicorandil)对心肌保存液保存效果的影响。方法 实验分为 4组 :UW液 (U)组 ;HTK液 (H)组 ;UW液组 +Nicorandil(U +N)组 ;HTK液 +Nicorandil(H +N)组 ;每组 8只大白鼠。麻醉和抗凝后 ,快速取下鼠心并悬挂在Langendorff灌注模型上灌注 ,测定血流动力学基础值。分别用四组保存液灌停离体鼠心并低温 (4℃ )浸泡保存 6h。复温、复灌后再次测定血流动力学值 ,留取标本分别测定心肌水含量、心肌酶漏出量、心肌细胞ATP和CP含量和心肌细胞超微结构变化。结果 心肌血流动力学恢复率 :H +N组>U +N组 >H组 >U组。心肌水含量 :4组间差异无显著意义。灌脉流出液中心肌酶漏出量 :H +N组 <H组 <U +N组 <U组。心肌中ATP和CP含量 :H +N组 >U +N组 >H组 >U组。心肌细胞超微结构变化 :H +N组心肌损害最轻 ,H组轻于U +N组 ,U组心肌损害最严重。结论 HTK液和UW液都是比较合适的心肌保存液 ,HTK液对心肌的保护作用优于UW液 ,钾离子通道开放剂Nicorandil能够善器官保存液HTK液和UW液对心肌的保存效果。

OBJECTIVE We investigated the efficacy of HTK solution and UW solution with Nicorandil(NCR) in the isolated rat heart models. METHODS The hearts were divided into four groups: UW solution (U ) group; HTK solution (H ) group; UW solution with Nicorandil (U+N )group; HTK solution with Nicorandil ( H+N) group. The hearts isolated from Wistar rats were mounted on a Langendorff apparatus to estimate baseline hemodynamic values. They were arrested and stored at 4℃ in each preservation solution for 6 hours. The recovery of myocardial function were measured. Myocardial tissue water content was evaluated. Myocardial tissue Adenosine Triphosphate (ATP) and Creatine Phosphate(CP) content in each group were also measured. The leakage of myocardial enzymes were measured as well. Finally,myocardial ultrastructure was observed. RESULTS The recovery rate of myocardial function: the group of H+N > the group of U+N > the group of H > the group of U. The myocardial tissue water content: there was no significant changes in four groups; The leakage of myocardial enzymes: the group of H+N < the group of H < the group of U+N < the group of U. The level of ATP and CP in myocardial tissue: the group of H+N > the group of U+N > the group of H > the group of U. The myocardial ultrastructure: The histological changes of myocardial cell and the damage of vascular endothelial cell were more significant in U+N group compared with that in H+N group. The histological changes were severer in U group than that in U+N group.CONCLUSION These results suggest that HTK solution is more effective than UW solution for myocardial preservation,and that NCR provides still better protection in the heart transplantation.