温血停搏液术终灌注对缺血再灌注心肌的保护作用

利用猫体外循环模型观察含甘露醇的温血停搏液术终灌注对缺血再灌注心肌的保护作用。心肌缺血恢复正常血液灌注前，从主动脉根部以５～６ｋＰａ的压力注入３７℃含甘露醇的低钾温血停搏液５０ｍｌ。结果显示用含甘露醇的温血停搏液术终灌注可保护缺血后再灌注心肌的功能，提高心肌能量储备，降低线粒体丙二醛含量。结论：含甘露醇的温血停搏液术终灌注，可提高心肌对氧自由基的清除能力，减轻线粒体膜脂质过氧化，提高心肌能量储备，有利于再灌注后心肌功能的恢复

Experimental Study of Terminal Reperfusion with Warm Blood Cardioplegia on Myocardial Protection

Aim:This study was designed to evaluate the protective effects of terminal reperfusion with warm blood cardioplegia on myocardial reperfusion injury.Clinical material and method:This strudy consisted of four groups of cats.Group I(n=8)was a normal control group and received no ischemic and reperfusion injuries.Group II(n=8)received cardiac arrest with St.Thomas solution for 60 minutes global hypothermia ischemia and no further reperfusion.Group III(n=8)an initial 60 minutes ischemia as same as group II was followed by 60 minutes of reperfusion with blood.Group IV(n=8)based on group II and followed by 60 minutes reperfusion with warm blood cardioplegic solution containing mannitol.The left ventricular function,myocardial levels of MDA and ATP were studied before myocardial ischemia and after reperfusion.Results:The hemodynamic indices were similar in all groups before myocardial ischemia.After reperfusion,the dp/dt max and dp/dt max showed markedly better recovery(P<0.05 and P<0.01,respectively),elevation of LVSP and LO(P<0.01)in group IV than in group III.The myocardial ATP level was significantly decreased after myocardial ischemia in group II,III and IV than in group I(P<0.01),but only in group IV increased significantly after reperfusion with warm blood cardioplegia(P<0.05).The myocardial MDA contents were increased after ischemia in all groups but it significantly increased after reperfusion in group III than in group IV(P<0.05).Conclusion:Warm blood cardioplegia with manniol for terminal reperfusion provides better myocardial function recovery by reduce postischemic and reperfusion injuries.