卡立泊来德复合心脏停跳液对兔未成熟心肌的保护作用

目的 比较选择性钠氢离子交换阻断剂卡立泊来德（Cariporide）联合不同心脏停跳液（St．Thomas液与HTK液）对未成熟心肌缺血／再灌注损伤的保护作用。方法32只新西兰幼兔（2-3周龄）,建立Langendorff离体心脏灌注模型后,随机分为4组,每组8只：对照组（st组,St．Thomas液）、HTK组（HTK液）、St＋C组（St．Thomas液中添加Cariporide）和HTK＋C组（HTK液中添加Cariporide）。所有心脏均30℃全心缺血120min,37℃KH液再灌注60min。记录心功能参数：左室发展压（LVDP）、左室最大收缩变化率（＋dp／dtmax）、左室最大舒张变化率（-dp／dtmax,）及冠脉流量（CF）;测定冠脉流出液中磷酸肌酸激酶同工酶（CK-MB）、心肌三磷酸腺苷（ATP）、丙二醛（MDA）、心肌细胞内钙（iCa）及心肌含水量（WC）。结果 HTK组LVDP、＋dp／dtmax、-dp／dtmax,、CF恢复率及ATP含量均明显高于St组（P〈0．05）,CK-MB、MDA、WC和iCa明显低于St组（P〈0．05）;St＋C组、HTK＋C组各指标分别优于st组、HTK组,且HTK＋C组各指标则优于st＋C组;而st＋C组与HTK组比较显示,St＋C组-dp／dt-、CF恢复率和ATP高于HTK组（P〈0．05）,而MDA高于HTK组（P〈0．05）,其余指标两组差异无统计学意义（P〉0．05）。结论Cariporide能提高St．Thomas液及HTK液对未成熟心肌缺血再灌注损伤的保护作用。

Cardioprotective effects of cariporide as an adjunct in different cardioplegic solutions: an experiment with rabbits

OBJECTIVE: To investigate the cardioprotective effects of cariporide as an adjunct in different cardioplegic solutions. METHODS: The hearts of 32 young New Zealand rabbits were isolated, hung on the Langendorff perfusion apparatus, arrested with 4 degrees C cardioplegic solutions to cause cardiac ischemia for 120 min, reperfused with 37 degrees C Krebs-Henseleit solution, and randomly divided into 4 equal groups: St. Thomas cardioplegic solution group (perfused with St. Thomas cardioplegic solution every 30 min), histidine-tryptophane-ketoglutarate (HTK) cardioplegic solution group (perfused with HTK solution, St. Thomas solution + cariporide (St + C) group (perfused with St. Thomas cardioplegic solution plus cariporide), and HTK solution plus cariporide (HTK + C) group (perfused with HTK cardioplegic solution plus cariporide). Multichannel physiological record instrument was used to record the left ventricular functions: left ventricular diastolic pressure (LVDP), maximum change rate of left ventricular systolic pressure rise and fall (+dp/dt(max)), maximum change rate of left ventricular diastolic pressure rise and fall (-dp/dt(max)), and coronary flow (CF). Automatic biochemical analyzer was used to measure the creatine kinase (CK)-MB, Then the level of ATP in the cardiac muscle cells was detected by high pressure liquid chromatography, the content of malonyldialdehyde (MDA) was detect by sulfur barbituric acid method. The calcium content (iCa) was measured by atomic absorption spectrophotometry. And the myocardial water content (WC) was measured too. RESULTS: The LVDP, +dp/dt(max), -dp/dt(max), CF recovery rate, and ATP content of the HTK group were all significantly higher than those of the St. Thomas group (all P < 0.05), and the CK-MB, MDA, WC, and iCa of the HTK group were all significantly lower than those of the St. Thomas group (all P < 0.05). The ATP level of the HTK + C group was significantly higher than those of the HTK and St + C groups (both P < 0.05), and the CK-MB, WC, MDA, and iCa of the HTK + C group were all lower than those of the HTK and St + C groups (all P < 0.05). The MDA level of the St + C group was significantly higher than that of the HTK group, and the ATP of the St + C group was significantly lower than that of the HTK group (both P < 0.05), however, there was no significant differences in CK-MB, WC, and iCa between these 2 groups (all P > 0.05). CONCLUSION: Cariporide enhances the cardioprotective effects of the St. Thomas and HTK cardioplegic solutions in immature myocardium.