| 引用本文： |
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王玺胜,汪发久,季强,等.Nicorandil超极化心脏停搏液对未成熟兔心肌的保护作用[J].同济大学学报（医学版）,2010,31(2):32-37. [点击复制]
- WANG Xi-sheng,WANG Fa-jiu,JI Qiang,et al.The study of the protective effects on immature rabbit myocardia with hyperpolarization cardioplegia drug Nicorandil[J].同济大学学报（医学版）,2010,31(2):32-37. [点击复制]
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| 摘要: |
| 目的观察不同浓度ATP敏感性钾通道开放剂尼可地尔（Nicorandil）超极化心脏停搏对未成熟兔心肌的保护作用，以提高婴幼儿手术中心肌保护效果。方法将32颗离体新西兰幼兔心脏随机分为4组：实验Ⅰ组、实验Ⅱ组、实验Ⅲ组、实验Ⅳ组，每组8颗。建立Langendorff离体灌注心脏模型，以KHB液体灌注30min后达平衡状态，转为工作模型。实验Ⅰ组间断灌注KHB液；实验Ⅱ组、实验Ⅲ组、实验Ⅳ组分别灌注ST．ThomasⅡ号停搏液、ST．Thomas1I号停搏液＋Nicorandil 10μmol／L、ST．ThomaslⅠ号停搏液＋Nicorandil100iμmol／L：每15rain重复1次，共灌注2次；然后用KHB液体再灌注30min，实验时间总共90min。实验开始、第60min及结束时各收集一次血流动力学指标：左室发展压（1eftventriculardevelopedpressure，LVDP）、左室舒张末压（1eftventricularend—diastolicpressure，LVEDP）、左室内压最大变化率（rateofriseofleftventricularpressure，＋dp／dt）及心肌酶指标：乳酸脱氢酶（1actatedehydrogenase，LDH）、肌酸激酶（creafinekinase，CK）。实验标本做病理切片观察心肌结构变化。结果实验Ⅲ组、实验Ⅳ组与实验Ⅰ组相比，血流动力学指标及心肌酶指标明显改善（P〈0．01），实验Ⅲ组、实验Ⅳ组与实验Ⅱ组相比，血流动力学指标及心肌酶指标明显改善（P〈0．05），实验Ⅱ组与实验Ⅰ组相比各项指标改善（P〈0．05），实验Ⅲ组的心功能恢复弱于实验Ⅳ组，但差异无统计学意义（P〉0．05）。镜下实验Ⅰ组、实验Ⅱ组心肌损伤重．实验Ⅲ组、实验Ⅳ组损伤较轻。结论单纯的高钾停跳液可以为未成熟兔心肌提供一定的保护作用。Nicorandil超极化心脏停跳液可以为未成熟兔心肌提供保护作用，且其保护作用明显优于单纯的高钾停跳液；但在实验范围内浓度的差别引起的保护作用差异不明显。 |
| 关键词: 尼可地尔 钾通道 未成熟心肌 心肌保护 |
| DOI：10.3969/j.issnl008-0392.2010.02.00B |
| 投稿时间：2010-01-14 |
| 基金项目: |
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| The study of the protective effects on immature rabbit myocardia with hyperpolarization cardioplegia drug Nicorandil |
| WANG Xi-sheng,WANG Fa-jiu,JI Qiang,CAI Jian-zhi,SUN Yi-feng,MEI Yun-qing |
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| Abstract: |
| Objective To evaluate the protective effects of hyperpolarization cardioplegia drug Nicorandil on immature rabbit myocardia at different concentrations in hope of improving the outcome in infant cardiosurgery. Methods Thirty-two hearts isolated from immature New Zealand rabbits were randomly assigned into 4 groups with 8 rabbits each. Animals in group Ⅰ suffered no cardioplegia as control; animals from group Ⅱ , Ⅰ and Ⅳ were all induced to have cardioplegia by adminstrating high potassium. Nicorandil was given to animals in group Ⅲ and Ⅳ at concentrations of either 10 μmol/L or 100 μmol/L. By means of Langendorff apparatus,the isolated heart in thermostat was perfused with KHB first for 30 min at 37 ℃ to reach for working status. Subsequently, isolated hearts in group Ⅰ, Ⅱ ,Ⅲ and Ⅳ were perfused by respective solutions by 20～25 ml in volume within 30 min. At the beginning,60th rain and the end of the experiment,the hemodynamic indexes including left ventricular developed pressure（LVDP）,left ventricular end-diastolic pressure （LVEDP） ,rate of left ventricular pressure rise（＋dp/dt） and myocardial enzymes like lactate dehydrogenase（LDH） and creatine kinase（CK） were measured. The pathologic changes of heart samples were also examined. Results In group m and group ]V ,the indexes of hemodynamic parameters and myocardial enzyme activities were significantly better than that in control animals （group Ⅰ ,P〈0.01） and in animals without Nicorandil treatment（group Ⅱ ,P〈0.05）. The indexes of group Ⅱ was better than group Ⅰ （P〈0.05）. Under light microscopy, the damage of heart muscle in group Ⅲ and group Ⅳ was less severe than that in group Ⅰ and group Ⅱ . Conclusion Hyperpolarization cardioplegia Nicorandil can give significant protective effects to myocardia in immature rabbit at a dose-independent fashion. Meanwhile single injection of high potassium cardioplegia can also give some protective effects. |
| Key words: Nicorandil potassium-channel opener immature myocardium myocardial protection |
