中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2011年
8期
1218-1221
,共4页
章庆春%尹海辉%严中亚%吴岳恒%肖学钧
章慶春%尹海輝%嚴中亞%吳嶽恆%肖學鈞
장경춘%윤해휘%엄중아%오악항%초학균
无博动供体%心脏移植%热缺血时间%家犬
無博動供體%心髒移植%熱缺血時間%傢犬
무박동공체%심장이식%열결혈시간%가견
Non-heart-beating donors%Heart transplantation%Warm ischemia time%Canisfamiliaris
目的 观察无博动供体(NHBDs)心脏可耐受热缺血的时限.方法 通过窒息法和放血法获得不同热缺血时间的家犬NHBDs心脏,以无热缺血心脏为对照组,其他各时间段为实验组,NHBDs心脏在4℃HTK液中保存2 h后进行原位心脏移植,供心复跳后继续辅助循环60min后撤机.监测再灌注3 h后的血流动力学参数,测定再灌注3 h后心脏组织含水量和超微结构改变.结果 窒息法获得的家犬NHBDs心脏能耐受的热缺血时间为16 min,热缺血17 min为其功能转折点;放血法获得的家犬NHBDs心脏能耐受的热缺血时间为27min,热缺血28min为其功能转折点.在热缺血安全时限点获得的NHBDs心脏用于移植后,窒息法NHBDs心脏的左室舒张功能(-dp/dtmax)要低于放血法NHBDs心脏(1361.68±231.47比1641.68±192.47,P＜0.05),但两者在左室收缩功能上差异无统计学意义(P＞0.05).结论 窒息法和放血法获得的家犬NHBDs心脏在耐受热缺血时都存在功能转折点,两者之间相差有11min.在热缺血安全时限内保存2 h的犬NHBDs心脏均成功用于移植,这为NHBDs心脏的初步活性判断提供实验依据.
目的 觀察無博動供體(NHBDs)心髒可耐受熱缺血的時限.方法 通過窒息法和放血法穫得不同熱缺血時間的傢犬NHBDs心髒,以無熱缺血心髒為對照組,其他各時間段為實驗組,NHBDs心髒在4℃HTK液中保存2 h後進行原位心髒移植,供心複跳後繼續輔助循環60min後撤機.鑑測再灌註3 h後的血流動力學參數,測定再灌註3 h後心髒組織含水量和超微結構改變.結果 窒息法穫得的傢犬NHBDs心髒能耐受的熱缺血時間為16 min,熱缺血17 min為其功能轉摺點;放血法穫得的傢犬NHBDs心髒能耐受的熱缺血時間為27min,熱缺血28min為其功能轉摺點.在熱缺血安全時限點穫得的NHBDs心髒用于移植後,窒息法NHBDs心髒的左室舒張功能(-dp/dtmax)要低于放血法NHBDs心髒(1361.68±231.47比1641.68±192.47,P＜0.05),但兩者在左室收縮功能上差異無統計學意義(P＞0.05).結論 窒息法和放血法穫得的傢犬NHBDs心髒在耐受熱缺血時都存在功能轉摺點,兩者之間相差有11min.在熱缺血安全時限內保存2 h的犬NHBDs心髒均成功用于移植,這為NHBDs心髒的初步活性判斷提供實驗依據.
목적 관찰무박동공체(NHBDs)심장가내수열결혈적시한.방법 통과질식법화방혈법획득불동열결혈시간적가견NHBDs심장,이무열결혈심장위대조조,기타각시간단위실험조,NHBDs심장재4℃HTK액중보존2 h후진행원위심장이식,공심복도후계속보조순배60min후철궤.감측재관주3 h후적혈류동역학삼수,측정재관주3 h후심장조직함수량화초미결구개변.결과 질식법획득적가견NHBDs심장능내수적열결혈시간위16 min,열결혈17 min위기공능전절점;방혈법획득적가견NHBDs심장능내수적열결혈시간위27min,열결혈28min위기공능전절점.재열결혈안전시한점획득적NHBDs심장용우이식후,질식법NHBDs심장적좌실서장공능(-dp/dtmax)요저우방혈법NHBDs심장(1361.68±231.47비1641.68±192.47,P＜0.05),단량자재좌실수축공능상차이무통계학의의(P＞0.05).결론 질식법화방혈법획득적가견NHBDs심장재내수열결혈시도존재공능전절점,량자지간상차유11min.재열결혈안전시한내보존2 h적견NHBDs심장균성공용우이식,저위NHBDs심장적초보활성판단제공실험의거.
Objective To study the warm ischemia time limit of non-heart-beating donors ( NHBDs) heart for transplantation. Methods The NHBDs heart endured different warm ischemia time limit by asphyxiation or depletion method in Canis familiaris ( 15 ± 3) kg, being harvested and preserved in 4 ℃HTK solution for transplantation. The NHBDs heart endured 0 min warm ischemia time as control. All NHBDs hearts were preserved for 2 h and transplanted to weight-matched recipients. The assist circulation was removed when the donor heart re-beat for 60 min, and the hemodynamic parameters were monitored at 3 h after reperfusion. Meanwhile, cardiac ultramicrostructure was also examined at 3 h after reperfusion. Results The warm ischemia time limit was 16 min in NHBDs heart induced by asphyxiation, and 27 min in NHBDs heart induced by depletion method in Canis Familiaris. The diastolic function of left ventricle ( - dp/dtmax) was decreased significantly in asphyxiation NHBDs heart ( 1361.68 ± 231.47 vs 1641.68 ±192.47 ,P ＜0. 05), but there was no significant difference in contractile function between asphyxiation or depletion Methods (P ＞ 0. 05 ). Conclusion The NHBDs heart harvested by asphyxiation or depletion method in Canis Familiaris all had a warm ischemia time limit and break point of function.
