摘要
目的 观察常温短暂热缺血后低温保存对供心的影响。方法 建立猪原位心脏移植模型 ,随机分为对照组 (C组 )和热缺血组 (H组 )。H组供心切取前常温缺血 5min。供心 4℃保存4h测定含水率、MDA、ATP含量 ,原位末端标记法检测心肌细胞凋亡 ;两组供心行原位心脏移植各8例 ,观察移植后血浆肌钙蛋白I(cTnI)水平、心排量 (CO )和再灌注 2h的心肌超微结构和凋亡。结果 与C组比较 ,H组供心低温保存后含水率、MDA高于C组 ,而ATP明显降低 ,差异均有显著性 (P <0 .0 5 ) ;C组cTnI漏出少 ,CO高于H组 (P <0 .0 5 ) ;H组心肌细胞结构改变明显 ,凋亡水平高于C组 (P <0 .0 1)。结论 热缺血使供心能量消耗 ,诱导再灌注后心肌细胞凋亡 ,一定程度上导致了供心移植后早期功能异常。
Objective To evaluate the effects of warm ischemia and hypothermic storage on donor heart in myocardial metabolism,ultrastructure and apoptosis.Methods Pig orthotopic heart transplantation models were establisted.Pigs were randomly divided into two groups:control group (group C) and warm ischemia group (group H).Donor hearts were arrested and stored with 4 ℃ Thomas solution.In group H,the donor hearts were subjected to 5-min ischemia at room temperature (28 ℃) before being cold arrested.After 4 h,water content,MDA and ATP in myocardial tissue were measured and ultrastructure was observed under an electron microscope.The donor hearts in the two groups (8 in each group) were subjected to orthotopic transplantations after stored at 4 ℃.Cardiac output (CO) and cTnI leakage after reperfusion were measured.Apoptosis of myocytes at 4 h of storage and 2 h after reperfusion was detected by using TUNEL methods.Results Compare with group C,heart tissue water content and MDA content were increased (P<0.01) and ATP decreased (P<0.01) in group H after storage for 4 h.After transplantation,CO was lower and cTnI level was higher in group H than in group C (P<0.05).Apoptosis was increased in both two groups after reperfusion for 2 h and much higher in group H than in group C (P<0.01).Ultrastructure significantly changed in the donors of group H.Conclusion Warm ischemia can deplete the energy of the donor heart,induce the apoptosis of myocytes after reperfusion,and lead to the abnormal function of the donor hearts after transplantation at early stage.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2004年第3期327-328,共2页
Chinese Journal of Experimental Surgery
基金
青岛市科委资助项目 (2 0 0 1KNS 2E 51 )
