腺苷预处理和缺血预处理心肌保护效果对比研究

To Investigate the Protective Effect of Adenosine Pretreatment and Ischemic Preconditioning

目的探讨心肌腺苷预处理和缺血预处理对离体大鼠心脏缺血/再灌注后心肌功能的影响。方法采用离体大白鼠工作心脏模型,比较腺苷预处理和缺血预处理对心肌缺血再灌前、后左室收缩压(LVSP)、左室舒张末期压(LVDEP)、左心室内压上升及下降最大速率(±dp/dtmax)、主动脉压(AP)、冠脉流量(CF)、心输出量(CO)、每搏心输出量(SV)和冠脉流出液乳酸脱氢酶(LDH),心肌三磷酸腺苷(ATP)含量、超氧化物歧化酶(SOD)活性、脂质过氧化物(LPO)含量及自灌注停搏液至完全停搏的时间(AT)。结果3组大鼠AT间差异有显著性意义(P<0.05),且Control组与其他两组间差异均有显著性意义(P<0.05)。3组大鼠停搏前、复跳后30minAP、LVSP、LVDEP、±dp/dtmax、SV、CF、Co间差异均有显著性意义(P<0.05)。3组大鼠ATP、SOP、LPO、LDH间差异亦均有显著性意义(P<0.05)。结论腺苷预处理和缺血预处理后产生相似的心肌保护作用,明显促进心肌缺血再灌后心肌功能的恢复,增进心脏的收缩功能、心肌ATP含量和SOD活性的恢复,减少LDH的漏出。腺苷预处理对心脏模拟体外循环的缺血再灌注损伤具有保护作用,具有临床应用价值。

Objective To investigate the protective effect of Adenosine Pretreatment （APT） and Ischemic Preconditioning （IPC） in isolated rat hearts which suffer from ischemia/reperfusion injury. Methods The model of Langendorff perfused isolated rat heart was used to study the effects of APT on left ventficular pressure （ LVP）, left ventricular end - diastolic pressure （LVDEP）, the maximal rate of rise and fall in left ventricular pressure （ ±dp/dt max）, aortic pressure （AP）, coronary flow （CF）, aortic flow （AF）, activities of lactate dehydrogenase （LDH） , superoxide dismutase （SOD） and lipid peroxidation （ LPO）, concentrations of ATP level pre - and post - ischemia/reperfusion. Results Compared with only ischemia/reperfusion group, APT and IPC enhanced the recovery of cardiac hemodynamics and promoted the recovery of contractile function, increased ATP level and SOD activity, and decreased leakage of intracellular lactic dehydrogenase. Conclusion APT and IPC have similar effects of anti - ischemia and reperfusion injury, and may play an important role in the future clinic cardiac surgery.