CAJ | 학술논문

目的：观察不同保存方法及不同灌注容量对猪离体供心冠脉血管因子表达和心肌细胞保护效果的影响。方法巴拿马小型香猪共36只，根据保存技术不同分为浸泡保存组和间断灌注保存组，间断灌注容量分别为50、100、150、200、250ml，每组6只。灌注液为30μmol/L二氮嗪强化Celsior液，保存温度为4℃，时间10h。保存后比较各组间冠脉血管中内皮型一氧化氮合成酶（eNOS）、内皮素-1（ET-1）、细胞黏附分子-1（ICAM-1）表达情况，以及心肌细胞凋亡情况、心肌组织ATP含量（ATPC）、心肌含水量（MWC）。结果间断灌注保存各组较浸泡保存组能维持较高的ATP水平，减少心肌细胞凋亡，降低MWC；而eNOSmRNA表达量高于浸泡保存组，ET-1mRNA和ICAM-1mRNA表达量却低于浸泡保存组（P＜0.05）。当灌注容量为50~200ml时，随着灌注容量的增加，ATPC和eNOSmRNA表达量逐渐增高，凋亡指数、MWC、ET-1mRNA和ICAM-1mRNA表达量则逐渐降低；继续增加灌注容量至250ml时，各指标并无显著变化。结论在长时间心脏保存中，每隔2h灌注1次，每次灌注容量为200ml能较好保护供心；当灌注容量低于200ml时，随着灌注容量的增加供心保护效果逐渐增强，且对冠脉和心肌的保护作用具有等同性。
목적：관찰불동보존방법급불동관주용량대저리체공심관맥혈관인자표체화심기세포보호효과적영향。방법파나마소형향저공36지，근거보존기술불동분위침포보존조화간단관주보존조，간단관주용량분별위50、100、150、200、250ml，매조6지。관주액위30μmol/L이담진강화Celsior액，보존온도위4℃，시간10h。보존후비교각조간관맥혈관중내피형일양화담합성매（eNOS）、내피소-1（ET-1）、세포점부분자-1（ICAM-1）표체정황，이급심기세포조망정황、심기조직ATP함량（ATPC）、심기함수량（MWC）。결과간단관주보존각조교침포보존조능유지교고적ATP수평，감소심기세포조망，강저MWC；이eNOSmRNA표체량고우침포보존조，ET-1mRNA화ICAM-1mRNA표체량각저우침포보존조（P＜0.05）。당관주용량위50~200ml시，수착관주용량적증가，ATPC화eNOSmRNA표체량축점증고，조망지수、MWC、ET-1mRNA화ICAM-1mRNA표체량칙축점강저；계속증가관주용량지250ml시，각지표병무현저변화。결론재장시간심장보존중，매격2h관주1차，매차관주용량위200ml능교호보호공심；당관주용량저우200ml시，수착관주용량적증가공심보호효과축점증강，차대관맥화심기적보호작용구유등동성。
Objective To compare the protective effect of different preservation methods on coronary endothelium and myocardium in isolated pig hearts. Methods Thirty six hearts isolated from Bama- miniature- pigs were divided into 6 groups:one static storage group and 5 intermittent perfusion groups with 6 in each group. Isolated heart in storage group were preserved in Celsior cardioplegia solution enhanced with diazoxide (DE, 30μmol/L) at 4℃for 10h;isolated hearts in perfusion groups un-derwent intermittent perfusion with 50,100,150,200 or 250ml solution respectively, every 2 h for 10 h. Then the samples of left ven-tricle and left anterior descending coronary artery were taken and apoptotic cardiomyocytes (AI), adenosine triphosphate con-centrations (ATPC), myocardial water content (MWC), endothelial nitric oxide synthase (eNOS), endothilin- 1 (ET- 1) and intercel-lular adhesion molecule- 1 (ICAM- 1) were measured. Results Compared with static storage group, the ATPC, eNOSmRNA in perfusion groups were significantly higher and AI, MWC, ET- 1mRNA, ICAM- 1mRNA were significantly lower. ATPC and eNOSm-RNA were gradual y increased and AI, MWC, ET- 1mRNA, ICAM- 1mRNA were gradual y reduced with the perfusion solution in-creasing in a range of 50ml to 200ml. There were no significant differences between 200ml and 250ml intermittent perfusion group. Conclusion Intermittent perfusion of preservation solution provides better protective effect on myocardium and endothe-lium of coronary artery in isolated donor hearts.