二亚乙基三胺预处理对低温保存后同种异体心脏移植的影响

Protective Effect of Delayed Preconditioning Response Induced by Diethylenetriamine on Ischemic Cold-stored Heart during Cardiac Transplantation

目的:研究二亚乙基三胺(DETA)迟发预处理反应(DPR)对低温保存的心脏移植供体的保护作用并探讨其可能机制。方法:32只青紫兰兔随机分成2组。一组作为移植受体组(n=16);另一组作为移植供体组,随机分成A、B 2个亚组(n=8),A组为预处理组,B组为对照组。A、B两组获取心脏后低温保存供体4 h,再移植到受体组建立心脏腹腔异位移植模型。检测受体组移植后心功能的恢复情况;心肌活性氧(ROS)、丙二醛(MDA)含量、Na+-K+-ATP酶活性;冠状动脉回血中的肌酸激酶(CK)、乳酸脱氢酶(LDH)、乳酸(LD)含量。结果:和B组相比DETA预处理组(A组)的供体有较好的心功能恢复,较少的CK、LDH的漏出,较高的Na+-K+-ATP酶活性,较少ROS、MDA、LD的生成。结论:DETA诱导的DPR,在心脏的获取-低温保存-移植后再灌注过程中,对心肌细胞有显著的保护作用。

Objective: To study protective effect and mechanisms of delayed preconditioning response(DPR) induced by Diethylen-etriamine on ischemic cold-stored heart during cardiac transplantation. Methods: Thirty-twe rabbits were randomly divided into two groups( n = 16 for each group). Group 1 was accepter-group. Group 2 was donor-group further randomly divided into group A and group B. In group A( n = 8), the pretreatment of rabbits were given Diethylenetriamine (DETA, 0. 1mg/kg-1 · 15 min-1, 4 times)24 hours before the hearts were arrested. Group B( n = 8) served as controls. The isolated hearts were stored in K-H solution at 4℃ for 4 before transplantation. Function, enzyme, metabolite and substructure of hearts were investigated after transplantation. Results: DPR induced by DETA provides a relative degree of cardioprotection demonstrated by significantly better preservation of left ventricular compliance; reduced leakage of creatine kinase(CK) and LDH; reduced generation of lactic acid(LD), reactive oxygen species(ROS) and malondialdehyde(MDA); improved activation of Na+-K+-ATP-enzyme and smaller degree of subceller destruction compared with controls ( P < 0. 05). Conclusion: These data support the concept that the cardioprotective effects of DPR of ischemic preconditioning can be streng thened by DETA.