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高碳酸血症性酸中毒预处理对兔心肌的影响。

The effect of hypercapnic acidosis preconditioning on rabbit myocardium.

作者信息

Luo Heguo, Chang Yetian, Cai Hongwei, Zou Wangyuan, Wang Deming, Guo Qulian

机构信息

Department of Anesthesiology, the Second Xiangya Second Hospital of Central South University, Changsha, 410013, China.

出版信息

J Huazhong Univ Sci Technolog Med Sci. 2008 Dec;28(6):706-10. doi: 10.1007/s11596-008-0621-8. Epub 2008 Dec 24.

Abstract

This study observed the protective effect of hypercapnic acidosis preconditioning on rabbit heart suffered from ischemia-reperfusion injury. Hypercapnic acidosis was established in animals with mechanical hypoventilation before ischemia-reperfusion. Thirty-two rabbits were randomly divided into 4 groups, with each having 8 animals in term of the degree of acidification: hypercapnic acidosis group A (group A), hypercapnic acidosis group B (group B), hypercapnic acidosis group C (group C), ischemia and reperfusion group (group IR). Animals in group IR were ventilated normally (tidal volume: 15 mL/kg, breathing rate 35 bpm). The PETCO(2) was maintained at the level of 40-50 mmHg for 30 min. Animals in groups A, B, C received low-frequency, low-volume ventilation to achieve hypercarbonic acidosis and the target levels of PETCO(2) were 75-85,65-75, 55-65 mmHg, respectively, with levels being maintained for 5 min. The animals then were ventilated normally to lower PETCO(2) to 40-50 mmHg. The left anterior branch artery of all the animals was ligated for 30 min and reperfused for 180 min. Then the infarct size was calculated. The cardiomyocytes were morphologically observed and ECG and hemodynamics were monitored on continuous basis. Acid-base balance was measured during procedure. Our results showed that the infarct size was (48.5+/-11.5)% of the risk area in the control group and (42.4+/-7.9)% in group C (P>0.05). Mean infarct size was significantly smaller in group B (34.5%+/-9.4%) (P<0.05 vs control group) and group A (31.0%+/-9.1%) (P<0.01 vs control group). It is concluded that HA-preconditioning can effectively protect the myocardium.

摘要

本研究观察了高碳酸血症性酸中毒预处理对兔缺血再灌注损伤心脏的保护作用。在缺血再灌注前通过机械通气不足在动物中建立高碳酸血症性酸中毒。32只兔根据酸化程度随机分为4组,每组8只:高碳酸血症性酸中毒A组(A组)、高碳酸血症性酸中毒B组(B组)、高碳酸血症性酸中毒C组(C组)、缺血再灌注组(IR组)。IR组动物正常通气(潮气量:15 mL/kg,呼吸频率35次/分钟)。呼气末二氧化碳分压(PETCO₂)维持在40 - 50 mmHg水平30分钟。A、B、C组动物接受低频、小容量通气以实现高碳酸血症,PETCO₂的目标水平分别为75 - 85、65 - 75、55 - 65 mmHg,各水平维持5分钟。然后动物正常通气使PETCO₂降至40 - 50 mmHg。所有动物的左前降支动脉结扎30分钟并再灌注180分钟。然后计算梗死面积。连续监测心肌细胞形态、心电图和血流动力学。在实验过程中测量酸碱平衡。我们的结果显示,对照组梗死面积为危险区的(48.5±11.5)%,C组为(42.4±7.9)%(P>0.05)。B组平均梗死面积显著小于对照组(34.5%±9.4%)(P<0.05),A组(31.0%±9.1%)(P<0.01 vs对照组)。结论是高碳酸血症性酸中毒预处理可有效保护心肌。

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