BQ123对体外循环缺血再灌注心肌胰岛素抵抗干预作用的实验研究

Effects of BQ123 Intervention on Myocardial Insulin Resistance During Myocardial Ischemia-reperfusion in Experimental Cardiopulmonary Bypass

目的:探讨内皮素受体拮抗剂BQ123对体外循环缺血再灌注心肌胰岛素抵抗(IR)的干预作用。方法:将18条杂种犬分为3组(n=6),Ⅰ组主动脉阻断30min,Ⅱ组主动脉阻断120min,Ⅲ组主动脉阻断120min且心脏停博液中加入BQ123。分别于体外循环转流前、主动脉开放后第15、45、75min4个时点,采集动脉、冠状静脉窦血液标本并进行右房心肌活检,测定各相关指标。结果:与Ⅱ组比较,Ⅲ组的动脉血糖、胰岛素、IR指数、应急激素、血浆内皮素-1及血浆肿瘤坏死因子-α水平升高幅度较小,心肌对葡萄糖的摄取和利用提前至再灌注45min,恢复至正常值更快(P<0.05或P<0.01)。结论:BQ123可以减轻体外循环缺血再灌注过程中的心肌IR,对其引起的损伤具有保护作用。

OBJECTIVE： To study the effects of endothelin - 1 receptor antagonist BQ123 to the myocardial insulin resistance （IR） in the course of myocardial ischemia - reperfusion during cardiopulmonary bypass（CPB）. METHODS： 18 healthy hybrid dogs were divided into three groups（n = 6）,group Ⅰ ： aortic crossclamp for 30 minutes,group Ⅱ ：aortic crossclamp for 120 minutes, group Ⅲ ： aortic crossclamp for 120 minutes with BQ123 treatment. After extracting the artery and sinus blood sample and biopsied at right atrium , the relative indexes were detected at pre- bypass, reperfused 15, 45 and 75 min respectively. RESULTS： Compared with group Ⅱ, The level of artery glucose, insulin, insulin resistance index , excitable hormones, endothelin - 1 and TNF- a in group Ⅲ increase less severely, the absorption and utilization of plasma glucose recover in 45 min earlier than that in group Ⅱ （P〈0.05 or P〈0.01） .CONCLUSIONS： BQ123 can relieve myocardial IR after ischemia-reperfusion in cardiopulmonary bypass and have protective effect on the injury.