CAJ | 학술논문

目的研究体外循环(CPB)期间循环开放时不同氧浓度复灌对心肌缺血再灌注损伤的影响.方法 30例大耳白兔随机分成3组(每组10只):A组为低氧流量复灌组,B组为中氧流量复灌组,C组为高氧流量复灌组;术中主动脉开放时分别以25、50、80ml/(kg·min)氧流量复灌5min;分别测定术前(T0)、主动脉开放30min(T1)、2 h(T2)、12 h(T3)、24h(T4)时血浆CK-MB与cTnT的水平;于建立体外循环前与主动脉开放60 min取右房心肌组织行湿/干重比(W/D)与丙二醛(MDA)、超氧化物岐化酶(SOD)含量测定和组织病理学检查.结果术后各时点3组兔血浆CK-MB与cTnT均较术前高(P<0.05),且A组兔血浆CK-MB与cTnT的水平较B、C组明显低(P<0.05);3组兔术后右房心肌W/D与MDA含量较术前明显升高,且A组明显较B、C两组低,而SOD含量刚好相反(P<0.05);电镜下观察发现术后3组兔右房心肌存在不同程度的线粒体水肿和损坏,嵴结构改变,基质颗粒减少,但A组相对较轻.结论低氧流量再灌注对兔心肌缺血再灌注损伤有保护作用.
목적 연구체외순배(CPB)기간순배개방시불동양농도복관대심기결혈재관주손상적영향.방법 30례대이백토수궤분성3조(매조10지):A조위저양류량복관조,B조위중양류량복관조,C조위고양류량복관조;술중주동맥개방시분별이25、50、80ml/(kg·min)양류량복관5min;분별측정술전(T0)、주동맥개방30min(T1)、2 h(T2)、12 h(T3)、24h(T4)시혈장CK-MB여cTnT적수평;우건입체외순배전여주동맥개방60 min취우방심기조직행습/간중비(W/D)여병이철(MDA)、초양화물기화매(SOD)함량측정화조직병이학검사.결과 술후각시점3조토혈장CK-MB여cTnT균교술전고(P<0.05),차A조토혈장CK-MB여cTnT적수평교B、C조명현저(P<0.05);3조토술후우방심기W/D여MDA함량교술전명현승고,차A조명현교B、C량조저,이SOD함량강호상반(P<0.05);전경하관찰발현술후3조토우방심기존재불동정도적선립체수종화손배,척결구개변,기질과립감소,단A조상대교경.결론 저양류량재관주대토심기결혈재관주손상유보호작용.
Objective To explore the effects of different oxygen flow rates during cardiopulmonary bypass(CPB) on myocardial ischemia-reperfusion (IR) injury in rabbits.Methods Thirty rabbits were randomized equally into groups A,B and Serum concentration of CK-MB and cTnT were tested by ELISA before the operation(T0)and after 30 min(T1),2 h(T2),12h(T3)and 24 h(T4)of reperfusion.W/D,SOD and MDA of the myocardium were determined before and at 60 min after reperfusion.The ultrastructural alterations of the myocardium were observed.Results Serum concentration of CK-MB and cTnT in the 3 groups increased significantly after the operation,and their levels were the lowest in group A(P<0.05).W/D and MDA in the myocardium was also the lowest,while SOD the highest in group A(P<0.05).Ultrastructural pathologies were found in all the 3 groups,but relatively mild in group A.Conclusion Low oxygen flow rate during controlled reperfusion may protect the myocardium from IR injury in rabbits.