兔心肌缺血-再灌注损伤冠脉血气变化研究

观察兔心肌缺血-再灌注损伤结扎前、缺血后20min和再灌注30min 3个不同时期冠状动脉血中氧分压(PcaO_2)、二氧化碳分压(PcaCO_2)、pH值、血氧饱和度(SaO_2)、氧含量(CaO_2)、实际碳酸氢盐(AB)、标准碳酸氢盐(SB)和剩余碱(BE)8项参数的变化规律,结果显示,除PcaCO_2和BE在灌注30min与结扎前无明显变化外,其余参数在缺血后20min和灌注30min均明显低于结扎前(P<0.01),且灌注后30min冠状动脉血中的pH、PcaO_2、SaO_2、CaO_24项参数也较缺血后20min显著降低(<0.01或P<0.05)。作者认为,低氧血症既是冠状动脉缺血造成的直接恶果,又是引起代谢性酸中毒的直接原因。低氧血症和代谢性酸中毒是加重心肌进一步损伤的两大主要因素。

Study on Blood-gas Changes in the Coronary Artery of Myocardial Ischemia Reperfusion Injury of Rabbit

In order to study the mechanism of the myocardial ischemia injury in rabbit partial pressure of oxygen (PcaO2) ,partial pressure of CO2(PcaCO2) ,pH ,oxygen saturation (SaO2),oxgen content (CaO2) ,actual bicarbonate (AB) , standard bicarbonate (SB) and base excess (BE) in the coronary artery were measured and analysed in the different periods. The results showed that 6 parameters of the above at 20 min after ischemia and 30 min after reperfusion were remarkably lower than those before ligating the coronary artery except Pca-CO2 and BE (P<0. 01) , pH ,PcaO2 ,SaO2 and CaO2 at 30 min after reperfusion were even lower than those at 20 min after ischemia (P<0.01 or 0.05). The authors consider that the hy-poxia is not only the worse outcome caused by the coronary artery ischemia but also the direct reason for the metabolic acidosis ,which are two major factors further injuring myocardium.