摘要
目的:在猪心肌缺血再灌注模型上,观察等容血液稀释和缺血预处理对再灌注损伤心肌的保护作用。方法:18头小型猪建立急性心肌缺血模型,随机分为3组:对照组(组Ⅰ,n=6),缺血预处理组(组Ⅱ,n=6),缺血预处理加血液稀释组(组Ⅲ,n=6),测定心排血量(CO),混合静脉血氧饱和度(SvO2,)、冠状动脉血流量,计算心肌氧供,氧耗量。于钳扎前、解除钳扎后20,60min分别测定血浆中丙二醛(MDA),SOD活性、磷酸激酶(CPK)及肌酸磷酸激酶同功酶(CK-MB),自左心耳剪下标本,测定HSP70mRNA表达率。结果:①缺缺血20min时3组MAP、CI及SVRI明显减低(P<0.01),但I组下降幅度明显大于II,III组。再灌注60min时,II组,III组HR明显低于对照值(P<0.01),III组HR的变化则无统计学意义,I组MAP,CI的下降幅度明显大I组和II组(P<0.05).②再灌注20min及60min时,III组的冠脉血流量明显大于I组(P<0.05)。③再灌注20min和60min时,3组CPK,CPK-MB均较对照值明显升高(P<0.05-0.01),组I的升高幅度明显大于组II,组III。组ⅠSOD值在再灌注20min,60min时逐步降低(P<0.05),组II,组IIISOD值有升高趋势,与对照值比较,无统计学意义。再灌注60min时,组ⅠMDA值明显高于组Ⅱ,组Ⅲ。④组ⅠHSP70mRNA表达低于组Ⅱ和组Ⅲ。
AIM:To observe the protective effects of isovolumetric blood dilution and isc hemia preconditioning against myocardial injury due to reperfusion through pig's myocardial ischemia reperfusion model. METHODS: Eighteen mini- pigs were used to establish acute myocardial ischemi a models. They were randomly divided into three groups, with 6 pigs for each gro up: the control group(group I,n=6),ischemic preconditioning group( group II,n=6) ,group of ischemic preconditioning plus blood dilution(Group III, n=6).Measure c ardiac output(CO),saturation of mixed venous blood oxygen( SvO2) ,blood flow o f coronary artery,and then calculate the oxygen supply to the myocardium and oxy gen consumption.The amount of malondialdehyde(MDA),the superoxide dismutase(SOD) activity, the creatine phosphokinase(CPK)and creatine phosphokinase isoenzyme(CK - MB)were also determined 20 min and 60 min respectively before and after the f orceps clamping.Take a sample from the left atrial appendage to determine the ra te of expression of heat shock proteins(HSP)70mRNA. RESULTS:After 20 min of ischemia,MAP,CI and SVR decreased more obviously in group I than in group Ⅱ and Ⅲ ( P< 0.01) 60 min after reperfusion, HR of gro up Ⅱ and Ⅲ was obviously lower than that of group I( P< 0.01) .The changes of HR of Group III did not have any statistical significance.20 min and 60 min after reperfusion, the blood flow of coronary artery of group Ⅲ was significan tly higher than that of group I (P< 0.05). Twenty min and 60 min after reperfusi on, the values of CPK and CK- MB increased obviously(P< 0.05-0.01),but their increasing amplitudes in group I were obviously greater than those of group Ⅱ and Ⅲ . 20 min and 60 min after reperfusion, the value of SOD of groupⅠ decr eased gradually(P< 0.05), and the value of SOD of group Ⅱ and group Ⅲ showe d an increasing tendency, but compared with the control group, there was no stat istical significance. 60 min after reperfusion, the value of MDA of groupⅠ wa s obviously higher than that of group Ⅱ and group Ⅲ . CONCLUSION:Isovolumetric blood dilution can strengthen the protection of prec onditioning against the ischemic myocardial injury caused by reperfusion.
出处
《中国临床康复》
CSCD
2004年第3期584-586,共3页
Chinese Journal of Clinical Rehabilitation
基金
上海市卫生系统"百人计划"资助项目(No.BR011)~~
