中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
Chinese Journal of Physical Medicine and Rehabilitation
2015年
9期
658-661
,共4页
心肺转流术%紫外线照射充氧自体血%心肌保护%线粒体
心肺轉流術%紫外線照射充氧自體血%心肌保護%線粒體
심폐전류술%자외선조사충양자체혈%심기보호%선립체
Cardiopulmonary bypass%Ultraviolet blood irradiation and oxygenation%Myocardial protection%Mitochondrion
目的 研究紫外线照射充氧自体血(UBIO)心脏停搏液对犬体外循环(CPB)心内直视手术时心肌线粒体的影响.方法 选取20只雄性杂交犬,按随机数字表法将其分为对照组和UBIO心脏停搏液组(UBIO组),每组10只.建立犬CPB心内直视手术模型,CPB中对照组使用普通含血心脏停搏液,实验组采用UBIO心脏停搏液.在阻断升主动脉前和开放升主动脉后,分别从冠状静脉窦取血,检测血清心肌肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)水平.在打开和关闭右心房时,分别取右心房组织标本,采用化学比色法检测组织匀浆线粒体超氧化物歧化酶(SOD)活性、谷胱甘肽过氧化物酶(GSH-Px)活性及丙二醛(MDA)含量,同时测定心肌线粒体膨胀度.结果 阻断升主动脉前,2组犬cTnI、CK-MB含量之间比较,差异无统计学意义(P＞0.05).在开放升主动脉后,对照组cTnI、CK-MB含量高于UBIO组,差异有统计学意义(P＜0.05).打开右心房时,2组犬心肌组织匀浆SOD活性、GSH-Px活性和MDA含量之间比较,差异无统计学意义(P＞0.05).关闭右心房时,2组犬心肌组织匀浆SOD活性、GSH-Px活性低于打开右心房时的SOD活性、GSH-Px活性(P＜0.05).2组犬关闭右心房时的MDA含量均高于组内打开右心房时的MDA含量(P＜0.05).关闭右心房时,UBIO组心肌组织匀浆SOD活性[(34.1±5.1)KNU/g]、GSH-Px活性[(44.2±7.4) kat/g]高于对照组SOD活性[(20.5±4.3)KNU/g]、GSH-Px活性[(32.7±6.3)kat/g],MDA含量[(6.9±1.2) mol/L]低于对照组[(9.5±1.9)mol/L] (P ＜0.05).UBIO组线粒体膨胀度改变较小.结论 CPB心内直视手术时存在心肌线粒体清除氧自由基能力下降及线粒体本身脂质过氧化反应,UBIO心脏停搏液可以保持线粒体清除氧自由基的能力,并减轻线粒体本身的受攻击程度,较好地维持线粒体结构与功能,减轻心肌损伤.
目的 研究紫外線照射充氧自體血(UBIO)心髒停搏液對犬體外循環(CPB)心內直視手術時心肌線粒體的影響.方法 選取20隻雄性雜交犬,按隨機數字錶法將其分為對照組和UBIO心髒停搏液組(UBIO組),每組10隻.建立犬CPB心內直視手術模型,CPB中對照組使用普通含血心髒停搏液,實驗組採用UBIO心髒停搏液.在阻斷升主動脈前和開放升主動脈後,分彆從冠狀靜脈竇取血,檢測血清心肌肌鈣蛋白I(cTnI)和肌痠激酶同工酶(CK-MB)水平.在打開和關閉右心房時,分彆取右心房組織標本,採用化學比色法檢測組織勻漿線粒體超氧化物歧化酶(SOD)活性、穀胱甘肽過氧化物酶(GSH-Px)活性及丙二醛(MDA)含量,同時測定心肌線粒體膨脹度.結果 阻斷升主動脈前,2組犬cTnI、CK-MB含量之間比較,差異無統計學意義(P＞0.05).在開放升主動脈後,對照組cTnI、CK-MB含量高于UBIO組,差異有統計學意義(P＜0.05).打開右心房時,2組犬心肌組織勻漿SOD活性、GSH-Px活性和MDA含量之間比較,差異無統計學意義(P＞0.05).關閉右心房時,2組犬心肌組織勻漿SOD活性、GSH-Px活性低于打開右心房時的SOD活性、GSH-Px活性(P＜0.05).2組犬關閉右心房時的MDA含量均高于組內打開右心房時的MDA含量(P＜0.05).關閉右心房時,UBIO組心肌組織勻漿SOD活性[(34.1±5.1)KNU/g]、GSH-Px活性[(44.2±7.4) kat/g]高于對照組SOD活性[(20.5±4.3)KNU/g]、GSH-Px活性[(32.7±6.3)kat/g],MDA含量[(6.9±1.2) mol/L]低于對照組[(9.5±1.9)mol/L] (P ＜0.05).UBIO組線粒體膨脹度改變較小.結論 CPB心內直視手術時存在心肌線粒體清除氧自由基能力下降及線粒體本身脂質過氧化反應,UBIO心髒停搏液可以保持線粒體清除氧自由基的能力,併減輕線粒體本身的受攻擊程度,較好地維持線粒體結構與功能,減輕心肌損傷.
목적 연구자외선조사충양자체혈(UBIO)심장정박액대견체외순배(CPB)심내직시수술시심기선립체적영향.방법 선취20지웅성잡교견,안수궤수자표법장기분위대조조화UBIO심장정박액조(UBIO조),매조10지.건립견CPB심내직시수술모형,CPB중대조조사용보통함혈심장정박액,실험조채용UBIO심장정박액.재조단승주동맥전화개방승주동맥후,분별종관상정맥두취혈,검측혈청심기기개단백I(cTnI)화기산격매동공매(CK-MB)수평.재타개화관폐우심방시,분별취우심방조직표본,채용화학비색법검측조직균장선립체초양화물기화매(SOD)활성、곡광감태과양화물매(GSH-Px)활성급병이철(MDA)함량,동시측정심기선립체팽창도.결과 조단승주동맥전,2조견cTnI、CK-MB함량지간비교,차이무통계학의의(P＞0.05).재개방승주동맥후,대조조cTnI、CK-MB함량고우UBIO조,차이유통계학의의(P＜0.05).타개우심방시,2조견심기조직균장SOD활성、GSH-Px활성화MDA함량지간비교,차이무통계학의의(P＞0.05).관폐우심방시,2조견심기조직균장SOD활성、GSH-Px활성저우타개우심방시적SOD활성、GSH-Px활성(P＜0.05).2조견관폐우심방시적MDA함량균고우조내타개우심방시적MDA함량(P＜0.05).관폐우심방시,UBIO조심기조직균장SOD활성[(34.1±5.1)KNU/g]、GSH-Px활성[(44.2±7.4) kat/g]고우대조조SOD활성[(20.5±4.3)KNU/g]、GSH-Px활성[(32.7±6.3)kat/g],MDA함량[(6.9±1.2) mol/L]저우대조조[(9.5±1.9)mol/L] (P ＜0.05).UBIO조선립체팽창도개변교소.결론 CPB심내직시수술시존재심기선립체청제양자유기능력하강급선립체본신지질과양화반응,UBIO심장정박액가이보지선립체청제양자유기적능력,병감경선립체본신적수공격정도,교호지유지선립체결구여공능,감경심기손상.
Objective To investigate the effect of cardioplegia solution of autologous blood treated with ultraviolet irradiation and oxygenation (UBIO) on myocardial mitochondrion in mongrel dogs underwent open heart surgery under cardiopulmonary bypass (CPB).Methods Twenty male mongrel dogs were randomly divided into a control group and a UBIO group, 10 dogs in each group.The UBIO group was infused with UBIO blood as the cardiac arresting solution via the ascending aorta, while the control group was given the same treatment except that the cardiac arresting solution was blood cardioplegia.Blood samples were taken from coronary venous sinus before cross-clamping and after aorta declamping to measure the levels of cardiac troponin I (cTnI) and creatinine kinase MB isozyme (CK-MB).For both groups, right atrial myocardial tissue samples were taken to detect the activity of myocardial mitochondrion superoxide dismutase (SOD), and glutathione peroxidase (GSH-PX) , and concentrations of malondialdehyde (MDA) when the right atrium was opened and closed.Results In both groups, the average levels of SOD and GSH-PX were decreased during CPB, and the decrease of SOD and GSH-PX were to a significantly larger extent in UBIO group (P ＜ 0.05).The concentrations of cTnI, CK-MB, and MDA in the control group were increased significantly higher than those in the UBIO group (P ＜ 0.05).Conclusion The attenuated lipid peroxidation of myocardial mitochondria plays an important role in myocardial protection by UBIO as cardioplegia solution in open heart surgery under CPB.
