冷自体血心脏停搏液对离体兔心肌能量代谢的影响

The Effect of Cold Autologous Blood Cardioplegia on Myocardial Energy Metabolism in Isolated Rabbit Heart

本研究通过对比冷自体血心脏停搏液、康斯特(HTK)液与改良托马斯停搏液对离体兔心室肌ATP、ADP、AMP含量及线粒体损伤程度的影响,探讨冷自体血心脏停博液对心肌的保护作用及机制。选择健康新西兰白兔60只,随机均分为3组,每组20只,建立Langendorff离体心脏灌注模型,分别灌以冷自体血停搏液、HTK液及St.Thomas液,应用高效液相色谱法测定心肌ATP、ADP、AMP含量,透射电镜下观察心肌线粒体损伤程度并评分。停跳前、复灌后3组之间冠状动脉流出液(CF)、心率(HR)及恢复百分比无统计学意义(p>0.05);A组、B组心肌含水量明显低于C组(p<0.05);A组、B组心肌ATP、ADP含量明显高于C组(p<0.01),3组间AMP含量差异无统计学意义(p>0.05);A组与B组心肌线粒体损伤程度及Flameng评分均较C组低,差异有统计学意义(p<0.05)。冷自体血停搏液可提高离体兔心肌细胞ATP、ADP含量,能减轻缺血-再灌注对离体兔心肌细胞线粒体的损伤。

This study compared the effect of cold autologous blood cardioplegia, HTK solution and modified Thomas cardioplegic solution on ATP, ADP, AMP content and the mitochondrial damage degree of isolated rabbit ventricular muscle to explore the protective effect and mechanism of cold autologous blood cardioplegia on myocardium. Sixty healthy New Zealand white rabbits were randomly divided into three groups with 20 rabbits in each group. Langendorff perfusion model for isolated hearts was constructed, and group A, B, C were perfused with cold autologous blood cardioplegia, HTK solution and St. Thomas solution, respectively. The content ofATP, ADP and AMP was measured by high performance liquid chromatography （HPLC）, and the degree of myocardial mitochondrial damage was observed under transmission electron microscope. The results showed that there were no statistical significances in Coronary flow （CF）, heart rate （FIR） and the percentage of HR recovery among three groups before heart beating and after reperfusion （0〉0.05）. Myocardial water content in group A and group B was obviouslylower than that in group C （0〈0.05）. While the contents of ATP and ADP in group A and group B were significantly higher than those in group C （0 〈0.01）, and the difference in the content of AMP in three groups was not statistically significant （0〉0.05）. In addition, the degree of myocardial mitochondrial damage and the Flameng score in group A and group B were lower than those in group C （0〈 0.05）. In conclusion, cold autologous blood cardiopIegia could improve the content ofATP, ADP and alleviated the damage ofischemia reperfusion injury on mitochondria in isolated rabbits.