Akagawa H, Tajiri T, Hoshino Y, Kumate M, Ishino T, Kosuga K, Ohishi K, Hitoshi T, Tsuda H, Koga M
J Cardiovasc Surg (Torino). 1983 May-Jun;24(3):215-21.
To evaluate the myocardial protective effect of glucose-insulin (GI) in a cold cardioplegic solution, we compared the effect of a solution not containing GI (solution I) with that of an identical solution containing GI (solution II) under cardiopulmonary bypass in mongrel dogs. After 120 minutes of ischemic arrest, defibrillation was necessary to restore cardiac activity in 12.5% of the solution I group and 42.8% of the solution II group, respectively. No distinct intergroup differences were noted in recovery of left ventricular function, oxygen and lactate extraction of the myocardium during the post-arrest period, the myocardial ultrastructure, and myocardial ATP levels. Although creatine phosphate was less well preserved, glucose-6-phosphate and lactate were more accumulated in the solution II group than in the solution I group. Thus, significant advantages of substrate enhancement by addition of GI to cold cardioplegic solution were not found in spite of multidose cardioplegia and presence of noncoronary collateral blood flow.
为评估葡萄糖 - 胰岛素（GI）在冷停搏液中的心肌保护作用，我们在杂种犬体外循环下，比较了不含GI的溶液（溶液I）与含GI的相同溶液（溶液II）的效果。缺血停搏120分钟后，溶液I组和溶液II组分别有12.5%和42.8%的犬需要除颤以恢复心脏活动。在停搏后时期，左心室功能恢复、心肌氧摄取和乳酸摄取、心肌超微结构以及心肌ATP水平方面，未观察到明显的组间差异。尽管磷酸肌酸保存较差，但溶液II组中6 - 磷酸葡萄糖和乳酸的积累比溶液I组更多。因此，尽管采用了多次剂量停搏液且存在非冠状动脉侧支血流，但在冷停搏液中添加GI增强底物并未发现显著优势。
