卡托普利对心肌组织高能磷酸化合物代谢的影响

The Effect of Captopril Added to St.Thomas Cardioplegic Solution and Reperfusion Blood on the Metabolism of Myocardial High Energy Phosphates

观察含卡托普利（巯甲丙脯酸）的停搏液及再灌注血液对心肌组织高能磷酸化合物代谢的影响。用杂种犬１６条，随机分为对照组（Ｓｔ．Ｔｈｏｍａｓ改型停搏液）、卡托普利（ｃｐｌ）组（含ｃｐｌ４．６μｍｏｌ／Ｌ的Ｓｔ．Ｔｈｏｍａｓ停搏液改型及再灌注血液）。测定心肌组织三磷酸腺苷（ＡＴＰ）、二磷酸腺苷（ＡＤＰ）、一磷酸腺苷（ＡＭＰ）、肌酸肌苷（ＣＰ）、丙二醛（ＭＤＡ）含量、股动脉及冠状静脉窦血气及乳酸值，计算心肌氧摄取率。结果表明，心脏复跳后ｃｐｌ组ＡＴＰ、ＡＤＰ、ＡＭＰ及ＣＰ的恢复率、心肌氧摄取率均明显高于对照组，而心肌组织ＭＤＡ含量、冠状静脉窦与股动脉的血乳酸含量差值明显低于对照组。提示含４．６μｍｏｌ／Ｌｃｐｌ的停搏液及再灌注血液可改善心肌组织氧的供需平衡，增加心肌组织氧摄取率及乳酸利用率，增加ＡＴＰ的合成。

Aim:The effect captopril to added to St.Thomas cardioplegic solution and reperfusion systemic blood on the metabolism of myocardial high energy phosphates were investigated.Method:Sixteen mongrel dogs were randomly divided into control and captopril groups.In the control group,only modified St.Thomas cardioplegic solution was used.In the captopril group,St.Thomas cardioplegic solution containing captopril 4.6μmol/L was employed for induction of cardiac arrest and the circulatory blood with the same concentration of captopril was adopted for reperfusion.The myocardial content of ATP,ADP,AMP and CP,the myocardial oxygen uptake ratio,and the lactate concentration in the femoral arterial blood and coronary sinus veinous blood were measured.Results:The recovery rates of myocardial contents of ATP,ADP,AMP and CP,the myocardial oxygen uptake ratio in the captopril group were significantly higher,while the differences between the amount of serum lactic acid in coronary sinuous venous blood and that in femoral arterial blood after reperfusion were significantly less than those in the control group.Conclusion:Addition of captopril(4.6μmol/L)to St.Thomas cardioplegic solution and reperfusion blood can improve the cardiac function by increasing the myocardial synthesis of ATP,the myocardial oxygen uptake ratio and the utilization of lactate acid.