高渗葡萄糖预灌注减轻大鼠心脏缺血再灌注损伤及心律失常

Hyperosmotic glucose perfusion attenuates ischemia and reperfusion injury and arrhythmia in isolated rat heart

目的观察高渗葡萄糖灌注液对正常大鼠离体心脏进行预灌注时心肌缺血再灌注引起的心律失常。方法采用Langendorff离体心脏灌注模型,以葡萄糖加入Krebs-Henseleit平衡灌注液中制成350及400mmol/L的高渗葡萄糖灌注液。采用健康雄性Sprague-Dawley大鼠30只均分为3组(对照组、高渗350组、高渗400组),分别预灌注大鼠心脏20min后,全心脏热缺血30min,高渗350组和高渗400组以高渗灌注液平衡灌注20min,对照组以正常渗透压平衡灌注液复灌30min,监测灌注过程中室性心律失常的变化,并测定冠状动脉流出液中磷酸肌酸激酶(CPK)、心肌超氧化物歧化酶(SOD)及过氧化氢酶(CAT)活性的变化。结果高渗350组和高渗400组心肌再灌注时冠状动脉流出液中CPK量均较对照组显著减少(P值均<0.01)。高渗400组的室性心动过速、心室颤动持续时间较对照组显著缩短(P<0.05)。高渗400组的心肌SOD及CAT水平均显著高于对照组(P值分别<0.01、0.05),高渗400组的心肌CAT又显著高于高渗350组(P<0.05)。结论高渗葡萄糖预灌注可改善大鼠离体心脏缺血再灌注损伤,该作用可能与高渗透压灌注增加心肌组织的抗氧化能力有关。

Objective To study the effect of hyperosmotic glucose perfusion on ischemia/reperfusion- induced arrhythmia in isolated rat hearts. Methods Rat hearts were perfused with normal or hyperosmotic Krebs- Henseleit buffer （350 and 400 mmol/L, by addition of glucose） for 20 min in Langendorff model. Thirty healthy male Sprague-Dawley rats were evenly randomized into 3 groups; control group, 350 mmol/L group and 400 mmol/L group. The heart underwent 30 min ischemia and 30 min reperfusion with normal Krebs-Henseleit buffer. Creatine phosphokinase in coronary outflow during reperfusion was assayed. Myocardial activity of superoxide dismutase and catalase and were also examined after ischemia. Results Pre-ischemic perfusion with 350 or 400 mmol/L hyperosrnotic glucose buffer significantly decreased coronary creatine phosphokinase as compared with normal Krebs-Henseleit buffer （ P〈0.01 ）. Perfusion with 400 mrnol/L hyperosmotic glucose markedly attenuated the arrhytl＇rnia, with the episodes of ventricular tachycardia and ventricular fibrillation significantly shortened compared with the control group （P〈0.05）. The activities of myocardial superoxide dismutase and catalase in 400 mmol/L group were significantly higher than those of the control group （ P〈0.05 or 0.01 ） and those of the 350 mmol/L group （P〈0.05）. Conclusion Hyperosmotic glucose can protect rat heart from ischemia-reperfusion injury and arrhythrnia, which might be related to the increase of antioxidative ability by hyparosmotic perfusate.