不同温度下缺血预处理对离体大鼠心脏缺血-再灌注损伤的心肌保护Protective effects of ischemic preconditioning with normothermia or hypothermia on schemia/reperfusion in-jury in isolated rat hearts
陈胜喜,殷桂林,袁明道,张殿堂,鲁尔雄
摘要(Abstract)：
观察离体大鼠Langendroff灌注心脏模型,37℃和30℃条件下,单次5min缺血、10min再灌注所形成的缺血预处理,对持续180min缺血、45min再灌注的心肌的保护作用.持续缺血期间控制心脏局部温度在20℃左右,并间隔30min经主动脉根部灌注St.Thomas晶体心麻痹液.实验发现,常温条件下,5min短暂缺血并不能引起大鼠心肌顿抑.常温下缺血预处理与晶体心麻痹液相结合,对离体大鼠灌注心脏缺血再灌注损伤的保护作用呈累加现象;低温下缺血预处理使预处理的心肌保护作用减弱,可能与心脏停跳前的快速降温有关;心肌顿抑不是预处理的可能机制;能量需求减少和细胞结构的保护可能是预处理的机制之一.
关键词(KeyWords)： 缺血预处理;心肌保护;晶体心麻痹液;离体大鼠心脏
基金项目(Foundation):
作者(Author): 陈胜喜,殷桂林,袁明道,张殿堂,鲁尔雄
参考文献(References)：
- [1]Murry CE,Jennings RB,Reimer KA,et al.Preconditioning with ischemia:a delay of lethal cell injury in ischemic myocardium.Circulation,1986,74:1124.
- [2]Lawson CS,Downy JM.Preconditioning:state of the art myocardial profection.Cardiovasc Res,1993,27:542.
- [3]Murry CE,Richard VJ,Reimer KA.Ischemic preconditionings slows energy metabolism and delays ultrastructural damage during a sustained ischemic episode.Circ Res,1990,66:913.
- [4]Cave AC,Hearse DJ.Ischemic preconditioning enhances postischemic function and reduces creatine kinase leakage in the rat heart even when used in conjunction with hypothermic cardioplegia. Circulation, 1992, 86 (Suppl I):I30.
- [5]Hull-Ryde EA, Lewis WR, Veronee CD, et al. Simple step gradient elution of the major high-energy compounds and their catabolites in cardiac. Muscls. Using high-performance liquid chromatography. J Chrombio, 1986, 377:165.
- [6]Yellon DM, Alkhulaifi AM, Pugsley WB.Preconditioning the human myocardium. Lancet, 1993, 342: 276.
- [7]Iilles RW, Wright JK, Inners-Mcbridek, et al. Ischemic preconditioning improves preservation with crystalloid cardioplegia. Ann Thorac Surg, 1994,8: 1481.
- [8]Cave AC,Hearse DJ. Ischemic preconditioning and contractile function: studies with normothermic and hupothermic global ischemia. J Mol Cell Cardiol, 1992, 24: 1113.
- [9]Aoki M, Nomura F, Mager JE, et al. Interactions between preischemic hypothermia and cardioplegic solution in the neonatal lamb heart.J Thorac Cardiovasc Surg, 1994, 107:822.
- [10]Rebeyka IM, Hanan SA, Borges MR, et al. Rapid cooling contracture of the myocardium. The adverse effect of prearrest cardiac hypothermia. J Thorac Cardiovasc Surg, 1990,100: 240.
- [11]Walker DM, Yellon DM. Ischemic preconditioning from mechenism to exploitation. Cardiovasc Res, 1992, 26:734.
- [12]Rouslin W,Broge CW,Grupp IL. ATP depletion and mitochodrial functional loss during ischemia in slow and fast heart-rate hearts. Am J Physiol, 1990, 259:H1759.