胎羊体外循环术后心脏和胎盘的代谢组学变化

Metabolomic changes of heart and placenta after fetal extracorporeal circulation in sheep model

目的探讨体外循环对胎羊心脏和胎盘组织代谢的影响,研究代谢改变与器官功能变化之间的关系。方法10只孕羊(孕90~120 d)随机分为两组,对照组胎羊仅开胸不建立体外循环(ECC),转流组胎羊开胸ECC转流1 h。实验期间监测胎羊血气和心肌酶,超声测量左右心室Tei指数、每搏输出量、脐动脉搏动指数和阻力指数。转流结束后,取胎羊的心脏和胎盘组织,进行非靶代谢组学检测,比较两组间的代谢组学差异。结果转流过程中转流组胎羊左右心室的Tei指数明显增加,心率和搏出量下降,脐动脉搏动指数和阻力指数无明显变化。转流组心脏代谢变化主要表现为脂肪酸代谢和氨基酸分解增强;胎盘代谢变化较小,转流组代谢组学结果与对照组无明显差异。结论胎羊ECC影响心脏功能,心脏组织分解代谢为主。短时间转流对胎盘功能影响较小,组织代谢改变不明显。

Objective To investigate the effects of extracorporeal circulation(ECC)on cardiac and placental metabolism and the relationship between metabolic changes and organ dysfunction in fetal sheep.Methods Ten pregnant ewes between 90 and 120 days of gestation were randomly divided into 2 groups.Fetal sheep in the bypass group underwent sternotomy and ECC for 1h,while those in the control group only underwent sternotomy.Blood gas values and myocardial enzymes of these lambs were monitored during bypass.The Tei index and stroke volume of ventricles,umbilical artery pulse index and resistance index were measured by ultrasound.After bypass,the heart and placenta tissues of fetal sheep were collected,and untargeted metabolomics based on UHPLC-MS/MS was performed to compare the changes in organ metabolomics between the two groups.Results The index of ventricles in the bypass group increased significantly,while the heart rate and stroke volume decreased.There was no significant change in umbilical artery pulse in⁃dex and resistance index.Fetal ECC had a great impact on cardiac metabolism,which mainly presented as increased fatty acid oxidation and amino acid decomposition.There was no significant difference in placental metabolomics between the two groups.Conclusion Fe⁃tal ECC could induce cardiac insufficiency.Changes in cardiac metabolism were characterized by catabolism.Fetal ECC had little effect on placental function in the short time,and there was no significant change in placental metabolism.