Sellevold O F, Jynge P
Thorac Cardiovasc Surg. 1985 Apr;33(2):65-70. doi: 10.1055/s-2007-1014090.
The influence of glucocorticoid supplementation to cardioplegic solutions is still open to debate. The isolated working rat heart model was used to test the efficacy of glucocorticoid (methylprednisolone sodium succinate (MPSS] supplementation to 2 clinical cardioplegic solutions. Hearts were subjected to either 80 minutes or 120 minutes of hypothermic (18.5 degrees C) global ischemia after single-dose administration (4 degrees C) of one of the cardioplegic solutions A ("Hamburg" solution) or B (simple potassium-based solution). Each cardioplegic solution was infused containing either MPSS in the clinically used concentration (250 mg/l or 500 mg/l for solution A and B, respectively) or without MPSS. The recovery of aortic flow, coronary flow, peak aortic pressure and heart rate was compared with preischemic control values. Creatine kinase (CK) release was measured in the early reperfusion period and the myocardial content of ATP was measured at 30 minutes of reperfusion. Solution B provided only a moderate protection against ischemic damage. Inclusion of MPSS 500 mg/l slightly improved the recovery of physiological indices, reduced CK leakage and increased myocardial ATP. Solution A provided a more effective protection against ischemia. The addition of MPSS in this situation did not affect the overall postischemic recovery. We suggest that the addition of MPSS may improve the protective properties of a cardioplegic solution when the ischemic injury is rather severe.
向心脏停搏液中添加糖皮质激素的影响仍存在争议。采用离体工作大鼠心脏模型来测试向两种临床心脏停搏液中添加糖皮质激素（琥珀酸甲泼尼龙（MPSS））的效果。在单剂量给予（4℃）心脏停搏液A（“汉堡”溶液）或B（简单钾基溶液）之一后，心脏经历80分钟或120分钟的低温（18.5℃）全心缺血。每种心脏停搏液在输注时分别含有临床使用浓度的MPSS（溶液A和B分别为250mg/L或500mg/L）或不含MPSS。将主动脉流量、冠状动脉流量、主动脉峰值压力和心率的恢复情况与缺血前对照值进行比较。在再灌注早期测量肌酸激酶（CK）释放，并在再灌注30分钟时测量心肌ATP含量。溶液B仅对缺血损伤提供中等程度的保护。加入500mg/L的MPSS可稍微改善生理指标的恢复，减少CK泄漏并增加心肌ATP。溶液A对缺血提供了更有效的保护。在这种情况下添加MPSS并不影响缺血后的总体恢复。我们认为，当缺血损伤相当严重时，添加MPSS可能会改善心脏停搏液的保护特性。
