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[冠状动脉反应性充血的实验研究——低温及钾停搏液的影响]

[Experimental study of coronary reactive hyperemia--effects of hypothermia and potassium cardioplegia].

作者信息

Umebayashi Y

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1989 Sep;37(9):1901-7.

PMID:2600463
Abstract

A hyperemic response on dog hearts following myocardial ischemia for 10 minutes has been studied in reference to myocardial protection with cardioplegia and hypothermia. Experimental animals were divided into four groups according to the difference in temperature and with or without cardioplegia during ischemia of the hearts. Group I (n = 7) succumbed to a normothermic ischemia. Group II (n = 6) had normothermic ischemia following infusion of 8 ml/kg of a normothermic cardioplegic solution. Group III (n = 7) had ischemia under moderate hypothermia (28 degrees C). Group IV [n = 7) had hypothermic ischemia following infusion of 8 ml/kg of hypothermic cardioplegic solution. A percent repayment of the flow debts in groups I, II, III, and IV were 234.6 +/- 38.3%, 101.5 +/- 40.8%, 134.5 +/- 50.0% and 112.8 +/- 36.5%, respectively. There was significant difference between group I and group II and IV (p less than 0.001) and group III (p less than 0.02). Peak flow in reactive hyperemia compared with control flow were 605.4 +/- 131.1%, 328.3 +/- 60.2%, 288.8 +/- 79.7% and 282.2 +/- 65.4% in each group I, II, III, and IV, respectively. The value in group I was significantly high in comparison with others (p less than 0.005). Depression of oxygen consumption was observed in groups with hypothermia as well as with cardioplegia. A hyperemic response was low in cardioplegia and/or hypothermia group. These data are suggestive of a beneficial use of cardioplegia and hypothermia on cardiac surgery through the observation of coronary reactive hyperemia after myocardial ischemia.

摘要

针对心脏停搏液和低温对心肌的保护作用,研究了犬心脏在心肌缺血10分钟后的充血反应。根据温度差异以及心脏缺血期间是否使用心脏停搏液,将实验动物分为四组。第一组(n = 7)死于常温缺血。第二组(n = 6)在输注8 ml/kg常温心脏停搏液后进行常温缺血。第三组(n = 7)在中度低温(28℃)下缺血。第四组[n = 7]在输注8 ml/kg低温心脏停搏液后进行低温缺血。第一、二、三、四组的血流债偿还百分比分别为234.6±38.3%、101.5±40.8%、134.5±50.0%和112.8±36.5%。第一组与第二组和第四组(p<0.001)以及第三组(p<0.02)之间存在显著差异。与对照血流相比,每组反应性充血的峰值血流在第一、二、三、四组中分别为605.4±131.1%、328.3±60.2%、288.8±79.7%和282.2±65.4%。与其他组相比,第一组的值显著更高(p<0.005)。在低温以及使用心脏停搏液的组中观察到氧消耗降低。心脏停搏液和/或低温组的充血反应较低。通过观察心肌缺血后的冠状动脉反应性充血,这些数据提示心脏停搏液和低温在心脏手术中具有有益作用。

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