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1.
目的 研究改良心肌保护液对短暂常温热缺血供心移植后的保护作用。方法  18只家猪随机分为 3组 ,对照组 (C组 ) :不缺血下供心低温灌注St.Thomas液后切取 ,4℃保存 4h后行原位心脏移植 ;热缺血组 (W组 ) :供心灌注低温St.Thomas保护液前常温缺血 5min ,4℃保存 4h后行原位心脏移植 ;改良心肌保护液组 (E组 ) :供心常温缺血 5min后用改良保护液灌注和保存 ,4℃保存 4h后行原位心脏移植。以心脏排出量 (CO)、心肌含水率、丙二醛(MDA)和ATP含量、肌钙蛋白I(cTnI)和心脏超微结构作为观察指标。结果 心肌含水率、MDA含量和cTnI含量E组明显低于W组 (P <0 .0 5 ) ;CO和ATP含量E组明显高于W组 (P <0 .0 5 ) ;E组与C组相比无显著差异 (P>0 .0 5 ) ;超微结构 ,E组损伤较W组明显减轻。结论 改良心肌保护液可有效改善供心因短暂常温热缺血而造成的结构和功能损害。  相似文献   

2.
改良心肌保存液热缺血冷保存对猪心保护的作用   总被引:1,自引:0,他引:1  
目的 研究改良心肌保存液在心脏移植术中对热缺血冷保存猪供心的心肌保存效果.方法 16对供猪随机分为2组,建立猪同种异体原位心脏移植模型.A组以St Thomas 液、B组以自制液作为停搏液、灌注冲洗液和保存液.供心心脏停搏热缺血5 min后,以停搏液灌注,切取心脏,4 ℃灌注冲洗并低温浸泡保存4 h,施行同种异体原位心脏移植.观察移植后心脏复搏的一般情况及血清肌酸激酶同工酶(CK-MB)变化,常规苏木精-伊红、PAS染色,光镜观察心肌组织.结果 浸泡保存后B组心肌含水量低于A组,复灌后CK-MB含量也低于A组(t=2.89~3.38,P<0.05).B组PAS糖原染色评分高于A组(T=24,P<0.01).结论 改良的新型心肌保存液能较好恢复热缺血冷保存的猪供心心脏功能,减轻复灌后的心肌再灌注损伤,减少保存期间细胞内糖原的消耗,其对心肌的保护明显优于St Thomas液.  相似文献   

3.
目的研究供心常温不同时间热缺血后细胞凋亡的变化。方法利用猪原位心脏移植实施方法,18只猪随机分为3组,对照组(C,n=6)灌注低温保护液后切取供心,4℃保存4h;热缺血1组(E1,n=6)常温阻断主动脉缺血5min后灌注低温保护液后切取供心;热缺血2组(E2,n=6)常温阻断主动脉缺血10min后,灌注低温保护液后切取供心。三组低温保存供心4h后分别行原位心脏移植。供心移植2h后取左心室心肌检测心肌细胞凋亡的变化。结果供心移植2h后,E1、E2组心肌细胞凋亡明显高于C组(P<0.01),E2组心肌细胞凋亡明显高于El组(P<0.01)。结论供心热缺血时间的延长增加移植后的心肌细胞凋亡的发生。  相似文献   

4.
①目的 研究肾缺血预处理对未成熟心肌保护作用 ,探讨未成熟心肌保护方法。②方法 建立心脏缺血预处理 (IP)和肾缺血预处理 (RIP)兔Langendorff灌注模型。将兔随机分为 3组。缺血 再灌注组 (I R组 ) :在Langendorff模型基础上 ,灌注 15min转为工作心 15min ;IP组 :在Langendorff模型基础上 ,灌注 15min转为工作心 15min ,反复 2次缺血 5min再灌注 5min ;RIP组 :反复 3次阻断左肾动脉血流 5min再灌注 5min ,建立模型 ,灌注 15min转为工作心 15min ;然后各组全心停止灌注 4 5min ,恢复灌注 15min改为工作心 30min。以左心室功能恢复情况、心肌含水量 (MWC)、血清肌酸激酶 (CK)和乳酸脱氢酶 (LDH)漏出率、心肌组织ATP和丙二醛 (MDA)含量、超氧化物歧化酶 (SOD)活性、心肌细胞内Ca2 + 含量、心肌线粒体Ca2 + ATPase活性及其Ca2 + 含量、心肌线粒体合成ATP能力 { [ATP]m}作为观察指标。③结果 RIP组和IP组左室功能恢复百分率高于I R组 (F =4 .6 7~6 .0 3,q =2 .6 0~ 3.12 ,P <0 .0 5 ) ,RIP组和IP组比较差异无显著性 (q =1.2 3~ 1.98,P >0 .0 5 ) ;RIP组和IP组MWC低于I R组 (F =5 .6 8,P <0 .0 5 ) ,RIP组和IP组比较差异无显著性 (q =1.6 5 ,P >0 .0 5 ) ;RIP组和IP组MDA含量、CK和LDH漏出率、ATP含  相似文献   

5.
目的研究低温含血保护液微流量持续灌注对热缺血猪心的保护作用,探讨心脏移植中供心保护的有效方法。方法24只离体猪心随机分为实验组(n=12,热缺血10min,4℃含血保护液持续灌注8h)和对照组(n=12,热缺血10min,4℃保护液浸泡保存8h),进行原位心脏移植,分别监测心脏复跳及血流动力学情况:心率(HR)、平均动脉压(MAP)、心输出量(CO),心肌肌钙蛋白T(cTnT)、肌红蛋白(Mb)水平。结果实验组心脏复跳情况、血流动力学优于对照组;对照组心肌蛋白显著高于实验组(P〈0.05)。结论低温含血保护液微流量持续灌注对热缺血猪心的心功能以及心肌组织有较好的保护作用。  相似文献   

6.
①目的 了解猪同种原位心脏移植术后早期一氧化氮 (NO)、一氧化氮合酶 (NOS)含量的变化 ,及其与早期缺血再灌注损伤的关系。②方法 建立猪同种原位心脏移植模型。供心在移植前低温保存 (Thomas液 ,4℃ ) 4h ,移植成功心脏复搏后 2h取材。应用组织化学方法测定心肌组织中NO、NOS的含量 ,应用核酸原位末端标记法 (TUNEL)测定心肌细胞凋亡指数 ,作为评价心肌缺血再灌注损伤的指标。以正常心肌及单纯缺血心肌组织作为对照。③结果 移植后心肌组织NO、NOS的含量较缺血组与正常组低 ,差异有显著意义 (F =2 7.2 2 9、16 .2 0 3,q =5 .716~ 6 .4 12 ,P <0 .0 1)。移植组心肌细胞凋亡指数与正常组及缺血组比较明显升高 ,差异有显著性(F =16 3.884 ,q =7.4 82、6 .975 ,P <0 .0 1)。心肌组织NO、NOS含量与心肌细胞凋亡指数呈负相关关系 (r =- 0 .886、- 0 .795 ,P <0 .0 1)。④结论 猪心脏移植后早期心肌缺血再灌注损伤所致的细胞死亡主要表现为心肌细胞凋亡 ;再灌注期间内源性NO、NOS的减少参与了心脏移植后早期缺血再灌注损伤的发生  相似文献   

7.
体外循环下心脏移植术心肌保护的体会   总被引:2,自引:0,他引:2  
目的实践一种心脏移植术中的心肌保护方法.方法缩短供心冷热缺血时间;供血选用Stanford大学心脏移植保存液灌注、保存,术中续灌用含血冷晶体停搏液;用大剂量白蛋白和FDP来减轻供心缺血再灌注损伤.结果患者移植术后心功能Ⅰ级.结论此种心肌保护方法行之有效.  相似文献   

8.
目的:观察含血Plegisol液持续微流量灌注对猪离体供心水肿的影响,探讨心脏移植中保护供心的有效方法。方法:28只瑞典家猪,随机分为实验组和对照组,每组14只,每组随机选7只为供体,7只为受体。实验组离体猪心在热缺血10min,4℃含血保护液持续微流量灌注10h后行原位心脏移植,对照组离体猪心在热缺血10min,低温静置10h后行原位心脏移植。主动脉开放24h后取心肌组织行组织学检查,记录24h冠状动脉平均血流量,计算心肌含水量。结果:组织学检查显示对照组冠脉内皮及心肌组织水肿程度比实验组严重;实验组冠状动脉平均血流量高于对照组,心肌含水量低于对照组(t=6.058和18.066,P<0.001)。结论:含血Plegisol液持续微流量灌注可显著减轻离体猪心冠脉内皮及心肌的水肿程度。  相似文献   

9.
目的:探讨缺血预处理结合低温晶体心麻液对心肌叠加保护作用及机制.方法:20只健康成年家兔随机均分为2组,采用改良的Langendroff灌注模型,对照组(C)经历缺血120 min再灌注45 min;实验组(E)在缺血再灌注前用单次5 min缺血再灌注10 min预处理.用生物发光法测定心肌中ATP含量,用生理八道仪测定心功能指标,透射电镜观察心肌超微结构.结果:①再灌注期间E组心律失常发生率明显低于C组(P<0.01);②实验结束观察心功能、生化、心肌能量代谢及心肌超微结构各项指标,E组明显优于C组(P<0.05).结论:在低温晶体心麻液保护措施下,缺血预处理也具有对心肌的保护作用.  相似文献   

10.
目的 研究选择性Na+ /H+ 交换抑制剂HOE6 4 2 (Cariporide)预处理对未成熟心肌缺血 /再灌注损伤的保护作用及机制。方法  2 0只健康新西兰幼兔 (3~ 4周龄 ) ,利用Langendorff左室做功模型灌注其离体心脏 ,建立全心缺血 /再灌注模型。KH液自主动脉逆行灌注心脏 ,向球囊缓慢注入生理盐水 ,调整至左室舒张末压 (LVEDP)为 10mmHg ,做功 2 0min ,随机分为两组 ,组Ⅰ :对照组 ,继续灌注 15min ;组Ⅱ :HOE6 4 2预处理组 ,用加入HOE6 4 2的KH液 (浓度为 5 μmol/L)继续灌注 15min。然后两组心脏均以St.Thomas停搏液诱导停跳 ,常温(37℃ )缺血 4 5min(保湿保温 ) ,再灌注 6 0min。记录冠脉流量 (CAF) ,多导生理记录仪记录左心功能指标 ,原子吸收分光光度计测定心肌细胞内钙 (Ca)含量 ,自动生化分析仪测量冠脉流出液中磷酸肌酸激酶 (CK)、磷酸肌酸激酶同工酶 (CK -MB)、乳酸脱氢酶 (LDH)漏出量含量 ,计算心肌含水量 ,透射电镜观察心肌超微结构改变。结果 CAF、左室发展压 (LVDP)、左室压力微分 (±dp/dtmax)恢复率 ,心肌组织内Ca及心肌含水量 ,心肌超微结构变化 ,HOE6 4 2预处理组明显优于对照组 (P <0 .0 5 )。结论 HOE6 4 2预处理通过减少细胞内钙超载 ,模拟缺血预处理的心肌保护效果 ,对未成熟心肌缺血 /  相似文献   

11.
Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P < 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (>0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P <0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P < 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.  相似文献   

12.
Objective: To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods: SD rats served as both donors and recipients. 4℃ sodium lactate Ringer's was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava (IVC) inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results: Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion: This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.  相似文献   

13.
Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P< 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P< 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.  相似文献   

14.
目的:评价使用安心颗粒对急诊经皮冠状动脉介入术(PPCI)术后生活质量的影响.方法:将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次)和对照组(仅接受基础药物治疗).所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表(MIDAS)、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果:入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异(P>0.05);出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低(P<0.05);组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低(P<0.05).两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血(P>0.05).两组发生轻度血小板减少症的患者数比较无差异(P>0.05).结论:PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.  相似文献   

15.
Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P<0.01);the MAP decreased(P<0.01)and the HR increased drastically(P<0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.  相似文献   

16.
Objective:To investigate the gene expression of osteoprotegerin(OPG) and osteoclast differentiation factor(ODF) in the bone tissue of patients with hip fracture due to osteoporosis. Methods:OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers(over 50 years old) with hip fracture(Observer Group) and 30 cases of hip facture sufferers with no osteoporosis(Control group) were analyzed with the Semi-Quantitative RT-PCR method. Results:The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion:Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.  相似文献   

17.
A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care(~'4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.  相似文献   

18.
Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.  相似文献   

19.
Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.  相似文献   

20.
Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.  相似文献   

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