不同心脏保存液对离体鼠心低温保存效果的对比研究

Effects of Different Heart Preservation Solution for Hypothermic Preservation of Isolated Rat Hearts

目的通过研究康斯特保护液(HTK液)和阜外改良液(FWM液)两种心脏保存液在低温条件下保存离体鼠心不同时间的效果,为临床应用提供依据,并探讨心脏移植手术过程中供心的临界保存时间。方法将36只雄性SD大鼠随机分成2组(HTK组和FWM组),每组18只。采用Langendoff装置进行心脏保存前后的灌注,各实验组分别使用不同保存液灌停心脏并在低温条件下保存鼠心8 h,于灌停前及复灌后留取冠脉流出液测定心肌酶(CKMB,LDH)漏出量。灌注结束后,取心肌组织测定含水量并制作光镜标本观察心肌组织结构变化。结果与FWM组比较,HTK组心肌酶漏出量较少,但仅有少数时间点存在显著性差异(P<0.05),心肌含水量稍低,但无显著性差异(P>0.05),心肌结构变化较轻。结论相同保存时间的条件下,HTK液及FW液的心肌保存效果相近,理论上应都可作为心脏移植术中供心的保存液,但与FWM液相比,HTK液仍具有一定优势。

OBJECTIVE To compare the efficacy of heart preservation of Histidine - Tryptophane - Ketoglutarate solution（ HTK solution ）and Fuwai modified solution （FWM solution）following 8 hours hypothermia preservation in the isolated rat heart mode. METHODS Male SD rats （n = 36） were divided randomly to two groups： HTK group and FWM group （n = 18 in each group）. The rat hearts were harvested and mounted on the Langendoff apparatus to perfuse with K -H buffer solution to estimate the leakage of enzymes of the myocardial tissue （CKMB, LDH）. Then they were arrested and stored in each preservation solution （4℃） for 8 hours. At the end of the storage period, the rat hearts were resumed and reperfused in Langendoff model. The water content and the leakage of enzymes of the myocardial tissue were measured. At the end of the reperfusion, the myocardial specimens were made to be observed the changes of structural through optical microscope. RESULTS The hearts stored in HTK solution have a lower level of water content and the leakage of enzymes of the myocardial tissue than those stored in FWM solution, but there were no significant differences （ P 〉0.05 ）. Also the changes of myocardial structural in FWM group were more remarkably than in HTK group. CONCLUSION The results suggest that HTK solution and FWM solution have comparable effective for hypothermie myocardial preservation in the same storage period.