自血心停跳液复灌对兔心肌保护的观察

Experimental Observation on the Protective Effect of Reperfusion with Cardioplegic Autogenous Blood upon the Postischemic Myocardium

采用两种不同的复灌方法，观察复灌早期自血心停跳液控制性灌注对缺血后心肌的保护作用。２０只离体兔心低温、多剂量冷晶体心停跳液维持停跳１５０ｍｉｎ后，随机分为，Ａ组立即恢复３７℃正常动脉血灌注３５ｍｉｎ，Ｂ组为复灌时先用高钾、高渗、碱化、富含Ｌ－谷氨酸的自体３７℃动脉血心停跳液低压灌注５ｍｉｎ，再以３７℃正常动脉血灌注３０ｍｉｎ。结果表明复灌期间Ｂ组释放入血的ＣＰＫ显著低于Ａ组（Ｐ＜０．０１）；心肌收缩力幅度高于Ａ组；心肌含水量较Ａ组显著减低（Ｐ＜０．０１）。显示复灌早期自血心停跳液控制性灌注，有助于减轻或限制心肌再灌注损伤，促进心肌恢复。

This study was undertaken to observe the protective effect of controlled initial reperfusion with warm cardioplegic autogenous blood in the upon the postischemic myocardium. Twenty isolated rabbit hearts were arrested with hypothermia and multiple doses of cold crystalloid cardioplegic solution for 150minutes.Then, in group A(n=10),the prolonged arrested rabbit hearts were immediately reperfused with normothermic(37℃)autogenous blood for 35 minutes ,while in group B(n=10) ,the prolonged arrested hearts were reperfused with 37℃cardioplegic autogenous blood for the first 5 minutes and then reperfused as in group A for 30 minutes.The results showed:the hearts of group B released significantly less CPK into the blood than Group A(P<0.01);the amplitude of myocardial contraction was greater or significantly greater in group B than in group A (except for P value of 10 minutes>0. 05,the other P values of 20、30 and 35 minutes all <0. 01);the myocardial water content was lower in group B than in group A(P< 0.01).The results suggest that controlled perfusion with normothermic cardioplegic autogenous blood in the initial phase of reperfusion can reduce the ischemic myocardial reperfusion injuries and promote the recovery of the heart function.