羟乙基淀粉对兔缺血-再灌注心肌 MPO 和 ET-1的影响

目的：观察羟乙基淀粉对兔缺血-再灌注损伤心肌髓过氧化物酶（MPO）、内皮素-1（ET-1）水平的影响。方法将36只新西兰大白兔随机分为乳酸林格氏液组（A组）、白蛋白组（B组）、羟乙基淀粉组（C组），每组12只。 A、B、C组于再灌注前15 min分别经颈内静脉缓慢注入6．0 ml/kg乳酸林格氏液、5％人体白蛋白6．0 ml、6％羟乙基淀粉6．0 ml，观察期间经耳静脉输注复方乳酸钠10 ml/（kg＆#183; h），于缺血前、缺血30 min，再灌注60 min、180 min 4个时点采血，检测血清乳酸脱氢酶（ LDH）、肌酸磷酸激酶（ CPK）、白细胞介素-8（ IL-8）和ET-1的浓度。再灌注180 min时处死大白兔测心肌梗死面积及 MPO活性。结果3组血清LDH、CPK、IL-8和ET-1水平随再灌注时间延长而逐渐升高，但C组增高的程度明显低于A、B两组（P＜0．05）；3组缺血区MPO活性均较非缺血区明显升高，升高程度A组＞B组＞C组（P＜0．05）；C组的心肌梗死面积显著小于A、B两组，B组梗死面积小于A组（P均＜0．05）。结论羟乙基淀粉可能通过抑制IL-8及ET-1的生成和释放，而降低缺血区MPO活性，对缺血-再灌注损伤的心肌组织具有保护作用。

Effect of Hydroxyethyl Starch on Myeloperoxidase and Endothelin-1 in Rabbits with Myocardial Ischemia-Reperfusion Injury

Objective To observe the effect of hydroxyethyl starch on myeloperoxidase （MPO） and endothelin-1 （ET-1） in rabbits with myocardial ischemia-reperfusion（MI/R） injury.Methods Thirty-six New Zealand rabbits were randomly divided into three groups：Lactated Ringer′s group（group A,n=12）,albumin group （group B,n=12） and hydroxyethyl starch group （group C,n=12）.The rabbits in group A,B,C were infused with Lactated Ringer′s solution （6 ml/kg）,5% human albumin （6 ml/kg）,6% hydroxyethyl starch （6 ml/kg）,respectively,through internal jugular vein 15 minutes before reperfusion ,and were infused with compound sodium lactate 10 ml/（kg＆#183; h）] through ear vein during observation period .Blood samples were obtained before occlusion ,30 minutes after occlusion ,60 and 180 minutes after reperfusion,respectively,to determine the levles of serum lactate dehydrogenase（LDH）,creatine phosphokinase（CPK）, interleukin-8（IL-8） and ET-1.The changes of myocardial infarction（MI） and MPO activity were examined following the rabbits had been killed 180 minutes after reperfusion.Results The activities of serum LDH ,CPK,IL-8 and ET-1 in the three groups increased gradually with increasing reperfusion time ,but the increase in group C was significantly lower than that in group A,group B（P〈0.05）.The activity of MPO in ischemic areas increased significantly compared with that in the non-ischemic areas in the three groups , which was the highest in group A but the lowest in group C （ P 〈0.05 ） . Myocardial infarct size in group C was significantly smaller than that in group A or group B ,which was smaller in group B in contrast with that in group A （all P〈0.05）.Conclusion Hydroxyethyl starch may reduce the activity of MPO in ischemic areas by preventing the production and release of IL-8 and ET-1, it can protect myocardium from ischemia-reperfusion injury .