Yotsumoto G, Moriyama Y, Yamaoka A, Taira A
Second Department of Surgery, Kagoshima University, Faculty of Medicine, Sakuragaoka, Japan.
Angiology. 1998 Apr;49(4):299-305. doi: 10.1177/000331979804900408.
This study is designed to evaluate the effect of hyaluronidase on the canine myocardial edema derived from ischemia/reperfusion injury. The mongrel dog's heart received 90 minutes of ischemia under cardiopulmonary bypass consisting of 30 minutes of normothermia alone and 60 minutes of hypothermia with cardioplegic arrest. Reperfusion for 60 minutes was added thereafter. Two kinds of cardioplegic solution, 4 degrees C St. Thomas' Hospital solution with or without 3000 units/L of hyaluronidase, were prepared. The solution was given antegradely every 30 minutes during cardioplegic arrest. Cardiac lymph was collected continuously from the afferent duct of the cardiac lymph node by cannulation. Hyaluronidase in the cardioplegic solution increased cardiac lymph volume significantly and improved postischemic recovery of cardiac function. A high level of adenosine triphosphate was maintained at that time. The myocardial water content at the end of reperfusion revealed a minimum increase with hyaluronidase use. Active drainage of cardiac lymph by hyaluronidase alleviates the myocardial edema formation, thereby preserving cardiac function.
本研究旨在评估透明质酸酶对犬缺血/再灌注损伤所致心肌水肿的影响。杂种犬心脏在体外循环下接受90分钟缺血，包括单独30分钟常温缺血和60分钟低温停搏缺血。此后再灌注60分钟。制备了两种心脏停搏液，即含或不含3000单位/升透明质酸酶的4℃圣托马斯医院心脏停搏液。在心脏停搏期间每隔30分钟顺行灌注该溶液。通过插管从心脏淋巴结的输入导管连续收集心脏淋巴液。心脏停搏液中的透明质酸酶显著增加了心脏淋巴液量，并改善了缺血后心脏功能的恢复。此时维持了高水平的三磷酸腺苷。再灌注结束时，使用透明质酸酶时心肌含水量的增加最小。透明质酸酶对心脏淋巴液的主动引流减轻了心肌水肿的形成，从而保护了心脏功能。
