Kyösola K T, Aalto-Setälä K, Harjula A L, Mattila S, Rechardt L
Scand J Thorac Cardiovasc Surg. 1986;20(1):89-92. doi: 10.3109/14017438609105921.
During open-heart surgery, myocardial biopsies were obtained before the start of extracorporeal circulation (from the right auricular appendage) and after weaning from the pump (from the right atrium), and processed for immunocytochemical demonstration of substance P- and leu-enkephalin-immunoreactive nerve fibres and for electron microscopy. Substance P-immunoreactive nerves were seen around blood vessels, between myocardial cells and forming large glomerulus-like loops, but were not numerous. Leu-enkephalin-immunoreactive nerves were very sparse. We therefore believe that both nerve types primarily are modulatory axons. In the post-weaning specimens, nerves of both types were more numerous (attributable to the different site of biopsy), and no change was seen in the immunofluorescence reaction. The ultrastructure (all types) of nerve terminals was well preserved, although myocardial damage was obvious in many specimens. Cardiac nerves, including peptidergic nerves, thus seem to be relatively resistant to ischaemia, hypothermic chemical cardioplegia and reperfusion injury.
在心脏直视手术中，于体外循环开始前（取自右心耳）及脱离体外循环后（取自右心房）获取心肌活检组织，并进行处理，以免疫细胞化学方法显示P物质和亮脑啡肽免疫反应性神经纤维，同时进行电子显微镜检查。可见P物质免疫反应性神经位于血管周围、心肌细胞之间并形成大的肾小球样环，但数量不多。亮脑啡肽免疫反应性神经非常稀少。因此，我们认为这两种神经类型主要都是调节性轴突。在脱离体外循环后的标本中，两种类型的神经数量更多（归因于活检部位不同），免疫荧光反应未见变化。尽管许多标本中可见明显的心肌损伤，但神经末梢的超微结构（所有类型）保存良好。因此，包括肽能神经在内的心脏神经似乎对缺血、低温化学性心脏停搏和再灌注损伤具有相对抗性。
