Sunamori M, Sultan I, Suzuki A
Department of Thoracic-Cardiovascular Surgery, Tokyo Medical and Dental University, School of Medicine, Japan.
Ann Thorac Surg. 1991 Oct;52(4):971-8. doi: 10.1016/0003-4975(91)91263-u.
Isolated canine hearts were preserved at 4 degrees C with multi-dose cardioplegic solution every hour for 6 hours. Reperfusion was observed for 2 hours under cross-circulation without cardiotonic drugs. The aprotinin group (n = 8), which received cardioplegic solution with added aprotinin (150 KIU/mL), was compared with the control group (n = 6). The increase in tissue adenosine triphosphate and total adenine nucleotide content during reperfusion was significant in the aprotinin group; there was no change in the control group, and the levels at the end of reperfusion tended to be higher in the aprotinin group than in the control group. Tissue adenosine diphosphate levels remained unchanged in both groups. Tissue adenosine monophosphate levels declined during reperfusion in both groups and were slightly lower in the control group. Tissue levels of cyclic adenosine monophosphate remained unchanged in the aprotinin group whereas they increased during ischemia and declined significantly during reperfusion in the control group. Tissue levels of cyclic guanosine monophosphate declined during reperfusion in both groups without difference. Creatine phosphate levels recovered in both groups without difference. Serum cyclic guanosine monophosphate concentration tended to be lower in the aprotinin group than in the control group. Serum creatine kinase-MB level increased slightly during reperfusion in both groups without difference. N-acetyl-beta-D-glucosaminidase levels were significantly suppressed during reperfusion in the aprotinin group as compared with the control group. These results suggest that aprotinin is effective in preserving adenine nucleotide and adenosine triphosphate levels and in stabilizing tissue cyclic adenosine monophosphate levels in prolonged hypothermic cardioplegic preservation followed by reperfusion.
将离体犬心在4℃下每小时用多剂量心脏停搏液保存6小时。在交叉循环且无强心药物的情况下观察2小时的再灌注情况。将接受添加抑肽酶（150 KIU/mL）的心脏停搏液的抑肽酶组（n = 8）与对照组（n = 6）进行比较。再灌注期间，抑肽酶组组织三磷酸腺苷和总腺嘌呤核苷酸含量显著增加；对照组无变化，且再灌注结束时抑肽酶组的水平倾向于高于对照组。两组组织二磷酸腺苷水平均保持不变。两组组织一磷酸腺苷水平在再灌注期间均下降，且对照组略低。抑肽酶组组织环磷酸腺苷水平保持不变，而对照组在缺血期间升高，在再灌注期间显著下降。两组组织环磷酸鸟苷水平在再灌注期间均下降，无差异。两组磷酸肌酸水平均恢复，无差异。抑肽酶组血清环磷酸鸟苷浓度倾向于低于对照组。两组血清肌酸激酶-MB水平在再灌注期间均略有升高，无差异。与对照组相比，抑肽酶组再灌注期间N-乙酰-β-D-氨基葡萄糖苷酶水平显著受到抑制。这些结果表明，在长时间低温心脏停搏保存后再灌注时，抑肽酶在保存腺嘌呤核苷酸和三磷酸腺苷水平以及稳定组织环磷酸腺苷水平方面是有效的。
