白细胞滤过器预防缺血再灌注心肌损伤的实验研究

Experimental Study of the Leukocyte Depletion Filter for Prevention of theMyocardial Reperfusion Injury

目的：探讨一种滤除再灌注血液中的白细胞以预防缺血再灌注心肌损伤的方法。方法：１６只家兔分实验组和对照组，建立体外循环心内直视手术模型。结果：实验组再灌注时外周血中白细胞数降至对照组的１９．５７％（Ｐ＜０．０１）；再灌注后白细胞发光强度，血清肌酸激酶及其ＭＢ同工酶和乳酸脱氢酶释放量及心律失常发生率较对照组明显减低（Ｐ＜０．０５）；术后心肌组织中丙二醛含量及白细胞数较对照组明显减少（Ｐ＜０．０１）；心肌组织超微结构损伤轻。结论：白细胞在再灌注心肌损伤中起重要作用，体外循环中加用白细胞滤过器对心肌有明显保护作用。

? Objective:To study an ideal method to avoid the myocardial reperfusion injury (MRI)through depleting leukocytes. Methods:Sixteen rabbits were randomly divided into leukocyte depletion group and control group.Animal model of cardiac surgery and cardiopulmonary bypass was established. Results:The leukocyte count of circulation in leukocyte depletion group was 1957% of that in control group at reperfusion(p<001).The polymorphonuclear chemiluminescence (PMNCL) creatine kinase (CK),creatine kinase isozyme (CKMB) and lactic dehydrogenase (LDH) release and the incidence of arrhythmias were lower in leukocyte depletion group than that in control group during reperfusion (p<005).The myocardial malondialdehyde (MDA) and leukocyte count were lower in leukocyte depletion group than that in control group 60 minutes after reperfusion (p<005).The ultrastructure of myocardium was less injured in leukocyte depletion group than in control group. Conclusion:The leukocyte play an important role in the MRI and the leukocyte depletion filter can protect myocardium from reperfusion injury in cardiopulmonary bypass.