温血停搏液控制性再灌注减轻缺血心肌再灌注损伤的实验研究

Effects of controlled reperfusion of warm blood cardioplegia on reducing myocardial ischemia/reperfusion injury in cat heart

目的:观察含甘露醇的温血停搏液控制性再灌注对缺血再灌注心肌的保护作用。方法：利用猎体外循环模型，心脏低温停搏60min，干恢复正常血液灌注前从主动脉根部以5～6kPa的压力注入37℃含甘露醇的低钾温血停搏液50ml。测定心肌力学各指标、心肌ATP及水含量。结果：急性心肌缺血再灌注后心功能明显减退，心肌水含量增加，心肌ATP含量恢复受限，出现再灌注损伤；而用温血停搏液控制性再灌注可减轻缺血心肌的再灌注损伤。结论：温血停搏液控制性再灌注可防止再灌注的缺血心肌暴发性水肿，增加心肌能量储备，有利于心功能恢复，减轻再灌注心肌的进一步损伤。

To test the hypothesis that the controlled reperfusion of warm blood cardioplegiacontaining mannitol would result in more effectively improved recovery of myocardial function by prevent-ing or reducing a potentially harmful component of reperfusion. Methods: Thirty-two cats were divided in-to four groups. Group Ⅰwas not subjected to ischemia or reperfusion injury. Group Ⅱ was subjected to60 min hypothermic ischemia. Group Ⅲwas subjected to 60 min hypothermic ischemia and 60 min reperfu-sion. Group Ⅳ was controlled reperfusion with warm blood cardioplegia containing mannitol. Results:Myocardial functlon was significantly depressed after 60 min reperfusion- Increased myocardial water con-tent and low ATP c0ntent were observed also. Controlled reperfusion with warm bl0od cardioplegia con-taining mannitol was helpful to improve the recovery of myocardial function and ATP content, and to re-duce the myocardial water content. Conclusion: These results indicate that controlled reperfusion after is-chemia provides benefit in avoiding myocardium from reperfusion injury.