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钙预处理对未成熟心肌的保护作用
引用本文:孙忠东,高尚志,王志维,邢建洲,毛志福. 钙预处理对未成熟心肌的保护作用[J]. 中华实验外科杂志, 2011, 28(3). DOI: 10.3760/cma.j.issn.1001-9030.2011.03.037
作者姓名:孙忠东  高尚志  王志维  邢建洲  毛志福
作者单位:1. 青岛大学医学院附属青岛市立医院心外科,266071
2. 武汉大学人民医院心外科
摘    要:目的 观察钙预处理对未成熟心肌的影响.方法 采用Langendorff离体灌注模型,分为3组,缺血再灌组(I/R):离体心脏灌注10 win、工作心15 min后停灌45 min恢复灌注15 min,转为工作心模型30 min;心脏缺血预处理组(IPC):离体灌注10 min转为工作心15 min,反复2次缺血5min/再灌5min,停灌45min后恢复灌注15min,转为工作心模型30min;钙预处理组(CP):离体心脏灌注10 min、工作心15 min后,反复3次45 s无钙KH液灌流/5 min KH液灌流,停灌45 min后恢复灌注15 min,转为工作心模型30 min.以血流动力学指标、生化指标和心肌超微结构作为观察指标.结果 IPC与CP组比较,血流动力学指标、生化指标和心肌超微结构等方面均无明显差异;CP、IPC与I/R组比较,左心室功能恢复、三磷酸腺苷含量(ATP)(11.53±1.85、13.40±1.96比4.27±0.83,P<0.01)、超氧化物歧化酶(SOD)活性(230.47±11.72、236.28±12.69比124.17±6.20,P<0.01)、心肌线粒体Ca2+ATP酶活性(17.86±1.39、16.38±1.27比6.78 ±0.64,P<0.01)和心肌线粒体合成ATP的能力(104.29±9.60、102.43±9.53比50.83±4.75,P<0.01)明显增强,在心肌含水量(75.32±1.25、73.29±1.26比84.23±2.03,P<0.01)、丙二醛含量(1.32±0.12、1.23±0.11比2.61±0.37,P<0.01)、肌酸激酶(53.17±5.32、57.47±5.62比123.65±9.63,P<0.01)和乳酸脱氢酶漏出率(32.16±3.23、34.48±3.43比85.43±5.93,P<0.01)、心肌细胞内(2.54 ±0.32、2.17±0.22比4.48±0.74,P<0.01)和心肌线粒体Ca2+含量(35.91±4.01、36.85±3.97比68.29±6.90,P<0.01)明显减少;CP、IPC组心肌超微结构损伤较I/R组明显减轻.结论 钙预处理对未成熟心肌具有明显保护作用
Abstract:
Objective To investigate the protective effects of Ca2+ preconditioning on isolated immature myocardium.Methods Isolated working rabbit heart model was used,and 18 rabbits were randomly divided into 3 groups:ischemic/reperfusion (I/R) group receiving 45 min ischemia followed by 45 min reperfusion;myocardial ischemic preconditioning (IPC) group receiving 5 min ischemia and 5 min reperfusion 2 times before 45 min ischemia followed by 45 min reperfusion;Ca2 + preconditioning (CP)group receiving no-Ca2 + preconditioning before 45 min ischemia followed by 45 min reperfusion.The hemodynamics,biochemistry and myocardial ultrastructure were tested.Results The hemodynamics,biochemistry and myocardial ultrastructure had no significant diferrence between CP group and IPC group.As compared with I/R group,in CP and IPC groups,the left ventricular function recovery,adenosine triphosphate content (ATP) (11.53 ± 1.85,13.40 ± 1.96 vs 4.27 ±0.83,P<0.01),superoxide dismutase (SOD)activity (230.47± 11.72,236.28 ± 12.69 vs 124.17 ±6.20,P<0.01),Ca2+-ATPase activity of mitothondia ( 104.29 ± 9.60,102.43 ± 9.53 vs 50.83 ± 4.75,P<0.01 ) and synthesized ATP activity of mitochondria ( 104.29 ±9.60,102.43 ±9.53 vs 50.83 ±4.75 ,P <0.01 ) were improved,and myocardial water content ( 75.32 ± 1.25,73.29 ± 1.26 vs 84.23 ± 2.03 ,P<0.01 ),malondialdehyde content ( 1.32 ± 0.12,1.23 ± 0.11 vs 2.61 ± 0.37 ,P<0.01 ),the dehydrogenase (32.16 ± 3.23,34.48 ± 3.43 vs 85.43 ± 5.93,P <0.01 ) and creatine kinase leakage (53.17 ±5.32,57.47±5.62 vs 123.65 ±9.63 ,P <0.01 ),myocardial cell Ca2+ content (2.54 ±0.32,2.17 ±0.22 vs 4.48 ±0.74 ,P <0.01 ) and mitochondrial Ca2+ content(35.91 ±4.01,36.85 ±3.97 vs 68.29 ±6.90,P <0.01 ) were reduced.The ultra.structure injury was milder in CP group and ICP group than in I/R group.Conclusion CP has signifcantly protective effects on immature myocardium.

关 键 词:未成熟心肌  钙离子  预处理  心肌保护

Ca2+ preconditioning on isolated immature cardioprotection
SUN Zhong-dong,GAO Shang-zhi,WANG Zhi-wei,XING Jian-zhou,MAO Zhi-fu. Ca2+ preconditioning on isolated immature cardioprotection[J]. Chinese Journal of Experimental Surgery, 2011, 28(3). DOI: 10.3760/cma.j.issn.1001-9030.2011.03.037
Authors:SUN Zhong-dong  GAO Shang-zhi  WANG Zhi-wei  XING Jian-zhou  MAO Zhi-fu
Abstract:Objective To investigate the protective effects of Ca2+ preconditioning on isolated immature myocardium.Methods Isolated working rabbit heart model was used,and 18 rabbits were randomly divided into 3 groups:ischemic/reperfusion (I/R) group receiving 45 min ischemia followed by 45 min reperfusion;myocardial ischemic preconditioning (IPC) group receiving 5 min ischemia and 5 min reperfusion 2 times before 45 min ischemia followed by 45 min reperfusion;Ca2 + preconditioning (CP)group receiving no-Ca2 + preconditioning before 45 min ischemia followed by 45 min reperfusion.The hemodynamics,biochemistry and myocardial ultrastructure were tested.Results The hemodynamics,biochemistry and myocardial ultrastructure had no significant diferrence between CP group and IPC group.As compared with I/R group,in CP and IPC groups,the left ventricular function recovery,adenosine triphosphate content (ATP) (11.53 ± 1.85,13.40 ± 1.96 vs 4.27 ±0.83,P<0.01),superoxide dismutase (SOD)activity (230.47± 11.72,236.28 ± 12.69 vs 124.17 ±6.20,P<0.01),Ca2+-ATPase activity of mitothondia ( 104.29 ± 9.60,102.43 ± 9.53 vs 50.83 ± 4.75,P<0.01 ) and synthesized ATP activity of mitochondria ( 104.29 ±9.60,102.43 ±9.53 vs 50.83 ±4.75 ,P <0.01 ) were improved,and myocardial water content ( 75.32 ± 1.25,73.29 ± 1.26 vs 84.23 ± 2.03 ,P<0.01 ),malondialdehyde content ( 1.32 ± 0.12,1.23 ± 0.11 vs 2.61 ± 0.37 ,P<0.01 ),the dehydrogenase (32.16 ± 3.23,34.48 ± 3.43 vs 85.43 ± 5.93,P <0.01 ) and creatine kinase leakage (53.17 ±5.32,57.47±5.62 vs 123.65 ±9.63 ,P <0.01 ),myocardial cell Ca2+ content (2.54 ±0.32,2.17 ±0.22 vs 4.48 ±0.74 ,P <0.01 ) and mitochondrial Ca2+ content(35.91 ±4.01,36.85 ±3.97 vs 68.29 ±6.90,P <0.01 ) were reduced.The ultra.structure injury was milder in CP group and ICP group than in I/R group.Conclusion CP has signifcantly protective effects on immature myocardium.
Keywords:Immature myocardium  Calcium ions  Preconditioning  Cardioprotection
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