Toshima Y, Mitani A, Kawachi Y, Konho H, Asou T, Nakamura Y, Oe M, Fukamachi K, Tanaka J, Tokunaga K
Nihon Kyobu Geka Gakkai Zasshi. 1989 Feb;37(2):337-43.
The purpose of this study is to evaluate the myocardial protective effects of two types of solution during heart transplantation procedure following cold storage in Collins' solution. Based on the concept whether the ischemic time during the procedure is an extension of heart storage or is an usual aortic cross-clamped ischemic time, we compared the effects of our cardioplegic solution (Group I) and Collins' solution (Group II) using isolated working rat heart model. After 30 minutes of global ischemia at 25 degrees C following 2 hours of cold storage, the hearts in Group I exhibited better functional recovery than those in Group II (% recovery of cardiac output was 61.1 +/- 5.4% in Group I and 42.4 +/- 7.4% in Group II, p less than 0.01). In Group II, marked elevation of coronary vascular resistance occurred on reperfusion. CPK release during reperfusion period was greater in Group II (0.41 +/- 0.24 IU/15 min/heart in Group I, 1.92 +/- 1.25 IU/15 min/heart in Group II, p less than 0.01). Myocardial metabolites contents (ATP, TAN, creatine phosphate and lactate) and energy charge were not significantly different between two groups. We conclude that it is harmful to ischemic myocardium to use Collins' solution as myocardial protection during transplantation procedure even if following cold storage in Collins' solution.
本研究的目的是评估在柯林斯溶液中冷藏后心脏移植过程中两种溶液的心肌保护作用。基于手术过程中的缺血时间是心脏保存时间的延长还是通常的主动脉交叉钳夹缺血时间这一概念，我们使用离体工作大鼠心脏模型比较了我们的心脏停搏液（I组）和柯林斯溶液（II组）的效果。在25℃下冷藏2小时后进行30分钟的全心缺血，I组心脏的功能恢复优于II组（I组心输出量恢复百分比为61.1±5.4%，II组为42.4±7.4%，p<0.01）。在II组中，再灌注时冠状动脉血管阻力显著升高。再灌注期II组的肌酸磷酸激酶释放量更大（I组为0.41±0.24IU/15分钟/心脏，II组为1.92±1.25IU/15分钟/心脏，p<0.01）。两组间心肌代谢物含量（三磷酸腺苷、总腺苷酸、磷酸肌酸和乳酸）和能荷无显著差异。我们得出结论，即使在柯林斯溶液中冷藏后，在移植过程中使用柯林斯溶液作为心肌保护对缺血心肌是有害的。
