含氧艾司洛尔停搏液对在体兔心保护作用的实验研究

目的在已完成的含氧艾司洛尔停搏液对离体猪心的保护作用的实验研究基础上,通过建立兔的体外循环模型,探讨含氧艾司洛尔作为停搏液对心肌的保护作用。方法通过建立兔的体外循环模型。18只家兔随机分为3组,即KHB组、St.ThomasⅡ组、含氧艾司洛尔组（Esmolol组）,每组6只。体外循环建立后,阻断主动脉根部,每隔10 min于主动脉根部灌注10ml停搏液（Esmolol 3 mol.L^-1,或St.ThomasⅡ液）,60 min后停体外循环,并行循环120 min。术中持续检测心脏血流动力学的变化,各组分别在体外循环结束后5 min、实验结束前5 min取5 ml血液离心留取血清作磷酸激酶同功酶（CK-MB）、肌钙蛋白（cTnI）。实验结束后取心肌组织测心肌湿干重比（W/D）与心肌中ATP的含量。结果18只家兔顺利建立体外循环,在体外循环结束后5 min及实验结束前5 min,Esmolol组和St.ThomasⅡ组体外循环结束后的左心室舒张末压（LVEDP）与KHB组比较均明显降低（P〈0.05）。各组的心率（HR）和平均动脉压（MAP）比较无显著性差异（P〉0.05）。含氧艾司洛尔组的心肌湿干重比（W/D）、CK—MB和cTnI与KHB组相比明显降低（P〈0．05），但心肌ATP的含量却明显高于KHB组（P〈0．05）。含氧艾司洛尔组与含氧St．ThomasⅡ组在上述指标方面的比较没有显著性差异（P〉0．05）。结论含氧艾司洛尔停搏液在体外循环心脏手术中具有良好的心肌保护作用，具有潜在的临床应用价值，为心脏停搏液的选择提供了另一种途径。

Experimental study of myocardial protection with oxygenated esmolol cardioplegia on in vivo rabbit heart

Aim To explore the myocardial protection of oxygenated esmolol solution as cardioplegia to in vivo rabbit heart.Methods The rabbit model of cardiopulmonary bypass（CPB） was established,18 rabbits were randomly allocated to three groups（6 in each group）,Krebs-Henseleit（KHB） group,St.Thomas Ⅱ group,oxygenated esmolol group（95%O2 and 5%CO2）.After establishment of cardiopulmonary bypass（CPB）,aortic root was blocked,10ml cardioplegia was infused every 10 min,60 min after cardiopulmonarybypass（CPB）,Parallel cycle 120min. Hemodynamics was measured continuously ,Sml blood was obtained after stop cardiopulmonary bypass（CPB） and at the end of the experiment respectively. The serum was collected to detect CK- MB ,cTnI. The wet to dry weight ratio （W/D） and ATP content in the myocardium were also measured at the end of the experiment. Result 18 rabbits succeeded in establishing a model of cardiopulmonary bypass. The levels of W/D, CK - MB, cTnl and ATP content in the myocardium became significantly lower in oxygenated esmolol group than those in oxygenated Kerbs- Henssleit （KHB） group （P 〈 0.05 ）, and without differences in the oxygenated St. Thomas II （ST） group （ P 〉 0.05 ）. Conclusion Oxygenated esmolol group has a good myocardial protection in cardiopulmonary bypass operation,which provided more options in clinical cardioplegia.