CAJ | 학술논문

目的检测内皮素、NO、丙二醛和超氧化物歧化酶(SOD)血液学指标及心肌组织局部内皮素受体A( ETA) mRNA的表达，评价体外循环不阻断升主动脉低温心室颤动左心室引流技术对心肌的保护作用，探讨更好的心肌保护方式。方法建立体外循环动物模型，实验动物分为对照组（停跳组）及实验组（心室颤动组），体外循环前、体外循环1h、体外循环2h、体外循环结束后1h4个时间点分别抽取静脉血，同时于各时间点分别钻取左心室壁局部心肌组织100 mg。测定血浆内皮素、NO、丙二醛和SOD水平。用逆转录聚合酶链反应方法检测心肌ETA mRNA的表达。结果随体外循环时间延长，2组内皮素、丙二醛水平均有升高。于体外循环2h和体外循环结束后1h两个时间点，对照组内皮素、丙二醛水平明显高于实验组[(70.27±7.03)ng/L比(56.53±12.11)rig/L,(106.36±6.61)ng/L比(72.71±12.72) rig/L; (4.71±1.31) μmol/L 比(3.32±0.82) μmol/L，(8.27±1.99) μmol/L比(4.38±1.02) μmol/L，均P＜0.01]；2组NO、SOD平均呈下降趋势，但实验组下降和缓，在后两个时间点，对照组NO、SOD水平明显低于实验组[(28.57±9.20)μmoVL比(45.36±16.59)μmol/L,(12.14±7.03)μmol/L比(47.50±17.18) μmol/L; (7.23±2.59) μg/L比( 17.69±7.96) μg/L，(2.78±0.88) μg/L比(18.52±10.30) μg/L，P＜0.05或P＜0.01]；2组ETA mRNA的表达水平均有升高，对照组升高幅度比实验组要高，体外循环1h、2h和体外循环结束后1h差异明显[(0.35±0.01)比(0.28±0.05),(0.49±0.05)比(0.31±0.04),(0.67±0.05)比(0.38±0.07),P＜0.01]。结论体外循环不阻断升主动脉低温心室颤动左心室引流技术对心肌具有良好保护作用。
목적 검측내피소、NO、병이철화초양화물기화매(SOD)혈액학지표급심기조직국부내피소수체A( ETA) mRNA적표체，평개체외순배불조단승주동맥저온심실전동좌심실인류기술대심기적보호작용，탐토경호적심기보호방식。방법 건입체외순배동물모형，실험동물분위대조조（정도조）급실험조（심실전동조），체외순배전、체외순배1h、체외순배2h、체외순배결속후1h4개시간점분별추취정맥혈，동시우각시간점분별찬취좌심실벽국부심기조직100 mg。측정혈장내피소、NO、병이철화SOD수평。용역전록취합매련반응방법검측심기ETA mRNA적표체。결과 수체외순배시간연장，2조내피소、병이철수평균유승고。우체외순배2h화체외순배결속후1h량개시간점，대조조내피소、병이철수평명현고우실험조[(70.27±7.03)ng/L비(56.53±12.11)rig/L,(106.36±6.61)ng/L비(72.71±12.72) rig/L; (4.71±1.31) μmol/L 비(3.32±0.82) μmol/L，(8.27±1.99) μmol/L비(4.38±1.02) μmol/L，균P＜0.01]；2조NO、SOD평균정하강추세，단실험조하강화완，재후량개시간점，대조조NO、SOD수평명현저우실험조[(28.57±9.20)μmoVL비(45.36±16.59)μmol/L,(12.14±7.03)μmol/L비(47.50±17.18) μmol/L; (7.23±2.59) μg/L비( 17.69±7.96) μg/L，(2.78±0.88) μg/L비(18.52±10.30) μg/L，P＜0.05혹P＜0.01]；2조ETA mRNA적표체수평균유승고，대조조승고폭도비실험조요고，체외순배1h、2h화체외순배결속후1h차이명현[(0.35±0.01)비(0.28±0.05),(0.49±0.05)비(0.31±0.04),(0.67±0.05)비(0.38±0.07),P＜0.01]。결론 체외순배불조단승주동맥저온심실전동좌심실인류기술대심기구유량호보호작용。
Objective To evaluate the protective effect of hypothermic ventricular fibrillation by analyzing the index endothelin, nitric oxide, malondiadehyde, superoxide dismutase (SOD) in blood and the expression of endothelin receptor A (ETA) mRNA in myocardium. Methods The animal model cardiopulmonary bypass (CPB)was estibalsed. Before CPB, at 1, 2 hours of CPB and 1 hour after heart re-beating, blood from vein was withdrew and myocardium was taken from the left ventricle of each dog. The blood level of nitric oxide( NO), malondialdehyde ( MDA), endothelin and SOD were tested, as well as the expression of the local left ventricular ETA mRNA using reverse transcriptase-polymerase chain reaction. Results The levels of endothelin, malondiadehyde in both groups were higher than normal. At 1,2 hours of operation and 1 hour after heart beating, the endothelin, malondiadehyde level of control group were higher than those of experimental group[(70. 27 ± 7.03 ) ng/L vs ( 56.53 ±12.11 ) ng/L, ( 106.36 ± 6.61 ) ng/L vs (72.71 ± 12.72) ng/L; (4.71 ± 1.31 ) μmol/L vs ( 3.32 ± 0. 82 ) μmol/L,(8.27 ± 1.99) μmol/L vs (4.38 ± 1.02) μmol/L,P ＜0.01]. The NO, SOD levels in both groups reduced but more significantly in control group. At 2 hours of operation and 1 hour after heart beating, the NO and SOD levels of experimental group were higher than those of control group[(28.57 ±9.20) μmol/L vs (45.36 ± 16.59) μmol/L,(12.14 ±7.03) μ mol/L vs (47.50 ± 17. 18) μmol/L; (7. 23 ±2.59)μg/L vs (17.69 ±7.96)μg/L, (2.78 ±0.88) μg/L vs ( 18.52 ± 10.30 ) μg/L, P ＜ 0. 05 or P ＜ 0.01]. ETA mRNA showed an increase in both two groups. Compared to experimental group, the ETA mRNA level in control group at 1, 2 hours of operation and 1 hour after heart beating was significantly higher[( 0. 35 ± 0. 01 ) vs ( 0. 28 ± 0.05 ), ( 0. 49 ± 0. 05 ) vs ( 0. 31 ±0.04),(0.67±0.05)vs(0.38 ±0.07),P＜0. 01]. Conclusion Myocardium is protected effectively by hypothermic ventricular fibrillation technique.