体外循环技术对建立山羊心肌缺血预适应模型的影响

Effect of cardiopulmonary bypass technique on goat ischemic preconditioning model

目的 :探讨体外循环 (CPB)技术对建立山羊心肌缺血预适应 (IPC)模型的影响。 方法 :1 2只雄性山羊右侧开胸 ,升主动脉插主动脉供血管 ,上、下腔静脉插腔静脉引流管 ,建立 CPB,阻断升主动脉 (ACC)、肺动脉 5 m in,开放恢复灌注 5 m in,并重复 3次 ,随后 ACC6 0 min,心脏停搏 ,后开放升主动脉心脏再灌注 90 min。CPB前及再灌注后 30、6 0、90 m in监测血流动力学及心功能。 结果 :1 2只山羊中 1 0只顺利脱离 CPB机 ,停机后血流动力学逐渐稳定 ;1只复跳后反复出现室颤 ,经多次除颤无效死亡 ;1只术后出现急性肺水肿死亡。平均转机时间 (1 36 .0± 1 3.0 ) min,平均预充胶体 (6 %贺斯代血浆或血 ) (5 5 0 .0±1 5 0 .0 ) ml,平均追加胶体 (1 75 .0± 5 0 .0 ) m l。再灌注后与 CPB前相比较 ,血流动力学及心功能恢复满意。 结论 :CPB保证下可模拟临床顺利完成山羊的 IPC实验。把握好几个关键的 CPB技术 ,可有效地提高山羊

Objective: To investigate the effect of cardiopulmonary bypass(CPB) technique on goat ischemic preconditioning(IPC)model. Methods: CPB was established through the right thoracotomy in 12 male goats. Three cycles of 5 min aortic cross clamping(ACC) and 5 min aortic unclamping were applied before goat hearts were subjected to 60 min ACC and followed by 90 min reperfusion. The hemodynamics and cardiac performance were monitored before CPB and 30 min,60 min, 90 min after reperfusion. Results: Ten of the IPC goats received CPB smoothly and the hemodynamics was stable after CPB discontinuation. Two goats died (one from ventricular arrhythmia despite of the effort of defibrillating for several times and one from acute pulmonary edema) after intervention. The mean CPB time was (136.0±13.0) min, the mean priming capacity (including Haes and Blood) was (550.0±150.0) ml and the mean supplementary capacity was (175.0±50.0) ml. In comparison to those before CPB,the recovery of hemodyanmics and cardiac performance were satisfactory after reperfusion. Conclusion: IPC can be smoothly performed on the goat CPB model mimicing the clinical setting. Proper performance of cardiopulmonary bypass technique is important for the successful establishment of goat IPC model.