CAJ | 학술논문

目的：在离体鼠心Langendorff灌注模型上，检验心肌保存液中加入ATP-K离子通道开放剂Nicorandil对心肌保存液保存效果的影响。方法：实验分为4组，UW液组、HTK液组、UW液组+Nicorandil组和HTK液+Nicorandil组，每组8只Wistar雄性大白鼠。麻醉和抗凝后，快速取下鼠心并悬挂在Laupeudorff灌注模型上灌注，37℃下测定血流动力学基础值。分别用四种保存液灌停离体鼠心并低温(4℃)保存4小时。重新复温复灌，再次测定血流动力学值，留取标本分别测定心肌水含量、心肌酶漏出量、ATP和CP含量和心肌细胞超微结构变化。结果：心肌血流动力学恢复率，HTK液组高于UW液组；UW液+Nicorandil组高于UW液组；HTK液+Nicorandil组高于HTK液组；HTK液+ Nicorandil组高于UW液+Nicorandil组。心肌水含量4组间差异无显著意义。灌脉流出液心肌酶漏出量，HTK液组低于UW液组；HTK液+Nicorandil组低于HTK液组；UW液+Nicorandil略低于UW液组。心肌中ATP和CP含量，HTK组高于UW组；HTK液+Nicorandil组高于UW液+Nicorandil组。心肌细胞超微结构变化，HTK液+Nicorandil组心肌损害最轻，HTK组轻于UW液+Nicorandil组，UW液组心肌损害最严重。结论：HTK液和UW液都是比较合适的心肌保存液，Nicorandil能够善心肌保存液的保存效果。
목적：재리체서심Langendorff관주모형상，검험심기보존액중가입ATP-K리자통도개방제Nicorandil대심기보존액보존효과적영향。방법：실험분위4조，UW액조、HTK액조、UW액조+Nicorandil조화HTK액+Nicorandil조，매조8지Wistar웅성대백서。마취화항응후，쾌속취하서심병현괘재Laupeudorff관주모형상관주，37℃하측정혈류동역학기출치。분별용사충보존액관정리체서심병저온(4℃)보존4소시。중신복온복관，재차측정혈류동역학치，류취표본분별측정심기수함량、심기매루출량、ATP화CP함량화심기세포초미결구변화。결과：심기혈류동역학회복솔，HTK액조고우UW액조；UW액+Nicorandil조고우UW액조；HTK액+Nicorandil조고우HTK액조；HTK액+ Nicorandil조고우UW액+Nicorandil조。심기수함량4조간차이무현저의의。관맥류출액심기매루출량，HTK액조저우UW액조；HTK액+Nicorandil조저우HTK액조；UW액+Nicorandil략저우UW액조。심기중ATP화CP함량，HTK조고우UW조；HTK액+Nicorandil조고우UW액+Nicorandil조。심기세포초미결구변화，HTK액+Nicorandil조심기손해최경，HTK조경우UW액+Nicorandil조，UW액조심기손해최엄중。결론：HTK액화UW액도시비교합괄적심기보존액，Nicorandil능구선심기보존액적보존효과。
objective: Nicorandil(NCR) exerts its action as an ATP-sensitive potassium channel opener at low extracellular potassium concentration. we investigated the efficacy of using HTK solution and UW solution with NCR following 4 hours hypothermia preservation in the isolated rat heart mode. Method: Hearts isolated from male Wistar rats were mounted on a Langendorff apparatus to estimate baseline hemodynamic values. The hearts were divided into four groups(n=8 per group): Group1, UW solution; Group2, HTK solution; Group3, UW solution with Nicorandil; Group 4 , HTK solution with Nicorandil. They were arrested and stored at 4℃ in each preservation solution for 4 hours. After the cold storage, the hearts were reperfused and the recovery of myocardial function [including Left Ventricular End-Diastolic Pressure(LVEDP), Left Ventricular Developed Pressure(LVDP), and the rate of change in Left Ventricular Pressure(+dp/dt, -dp/dt) ]were measured. Myocardial tissue water content was evaluated. Myocardial tissue Adenosine Triphosphate (ATP) and Creatine Phosphate(CP) content in each group were also measured just after cold storage. The leakage of myocardial enzymes were measured as well. Finally, myocardial ultrastructure was observed. Result:The recovery rate of myocardial function:The group of HTK was better than that in the group of UW (P<0.05); the group of HTK solution + Nicorandil was better than that in the group of HTK (P<0.05); The level of ATP and CP in myocardial tissue: the group of HTK was significantly better than that in the group of UW (P<0.01); HTK solution + Nicorandil was better than that in the group of HTK (P<0.05); group of HTK solution + Nicorandil was better than that in the group of UW solution with Nicorandil (P<0.05). There were no significant changes in the myocardial tissue water content of four groups; The leakage of myocardial enzymes: the group of HTK was better than that in the group of UW (P<0.05); The myocardial ultrastructure: The histological changes of myocardial cell and the damage to vascular endothelial cell were more significant in UW solution+nicorandil group compared with that in the HTK solution+nicorandil group. The histological changes were severer in UW solution group than that in the UW solution+nicorandil group. Conclusion:These results suggest that HTK solution is more effective than UW solution for myocardial preservation, and that NCR provides still better protection in the heart transplantation.