心脏停搏液冲洗、保存及再灌注对猪冠状动脉循环的影响。
Effects of cardioplegic flushing, storage, and reperfusion on coronary circulation in the pig.
作者信息
Budrikis A, Liao Q, Bolys R, Westerlaken B, Steen S
机构信息
Department of Cardiothoracic Surgery, University Hospital, Lund, Sweden.
出版信息
Ann Thorac Surg. 1999 May;67(5):1345-9. doi: 10.1016/s0003-4975(99)00262-3.
BACKGROUND
The aim of the study was to investigate how flush-perfusion of the heart with cold cardioplegic solution, 2 or 12 hours of cold ischemic storage, and 24 hours of reperfusion affect coronary endothelial function and coronary vascular resistance.
METHODS
Porcine coronary arterial endothelial and smooth muscle function was studied in organ baths. An adult porcine working heart model was used to investigate coronary vascular resistance after 24 hours of reperfusion.
RESULTS
Flushing the heart with 1 L of St. Thomas' cardioplegic solution, using a perfusion pressure of 60 to 65 mm Hg, significantly reduced endothelium-dependent relaxation. Flushing followed by 12 hours of storage gravely impaired endothelium-dependent relaxation, and 24 hours of reperfusion worsened it still more.
CONCLUSIONS
Flushing the heart with cold cardioplegic solution impairs endothelium-dependent relaxation, as does prolonged cold ischemic storage. Reperfusion of injured coronary endothelium may injure it still more. A correlation was found (p < 0.001) between high coronary vascular resistance and low endothelium-dependent relaxation.
背景
本研究的目的是探讨用冷心脏停搏液对心脏进行冲洗灌注、2或12小时的冷缺血保存以及24小时的再灌注如何影响冠状动脉内皮功能和冠状动脉血管阻力。
方法
在器官浴槽中研究猪冠状动脉内皮和平滑肌功能。使用成年猪工作心脏模型研究再灌注24小时后的冠状动脉血管阻力。
结果
用1升圣托马斯心脏停搏液以60至65毫米汞柱的灌注压力冲洗心脏，显著降低了内皮依赖性舒张。冲洗后进行12小时的保存严重损害了内皮依赖性舒张，而24小时的再灌注使其进一步恶化。
结论
用冷心脏停搏液冲洗心脏会损害内皮依赖性舒张，长时间的冷缺血保存也是如此。受损冠状动脉内皮的再灌注可能会使其进一步损伤。发现高冠状动脉血管阻力与低内皮依赖性舒张之间存在相关性（p < 0.001）。
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