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在离体灌注大鼠心脏的缺血再灌注损伤中,向圣托马斯医院心脏停搏液中添加等胶体渗透压合成胶体无有益作用。

No beneficial effects of isocolloidoosmotic synthetic colloid addition to St. Thomas Hospital cardioplegic solution in ischemia-reperfusion injury in isolated perfused rat hearts.

作者信息

Süzer O, Köseoğlu S, Han G

机构信息

Department of Pharmacology, Istanbul University, Cerrahpaşa Faculty of Medicine, Turkey.

出版信息

Gen Pharmacol. 1999 Jan;32(1):101-5. doi: 10.1016/s0306-3623(98)00091-3.

DOI:10.1016/s0306-3623(98)00091-3
PMID:9888261
Abstract
  1. Cardioplegic solutions provide the opportunity to operate on a nonbeating heart and to protect the heart against ischemic injury during cardiac surgery. The components of these solutions are constantly being modified in an effort to find the optimal solution. We studied the effects of colloidal volume replacers such as dextran, HES and gelatin as an isocolloidoosmotic addition to St. Thomas Hospital cardioplegic solution in ischemia-reperfusion injury of isolated rat hearts. 2. In the control group, after a stabilization period of 20 min, the hearts were arrested with St. Thomas Hospital cardioplegic solution for 3 min, then subjected to 30 min of global ischemia. Hearts then were reperfused for 10 min. In the experimental groups, the protocol was the same, but either HES 200/0.5 (50 g/L), modified fluid gelatin (30 g/l) or dextran 70 (25 g/L) were added to the St. Thomas Hospital solution. 3. All hearts were compared for their preischemic and postischemic contractility, heart rate, contractility rate product, coronary flow, lactate dehydrogenase, creatine phosphokinase enzyme leakage and wet/dry weight ratio. 4. All groups had similar contractility (for control, HES, gelatin and dextran groups the values at minute 10 of reperfusion were 59+/-9, 56+/-11%, 61+/-14%, 49+/-14% of initial values [P>0.05, respectively]) and enzyme leakage (lactate dehydrogenase 4.1+/-1.0, 8.1+/-1.5, 5.8+/-1.4, 3.7+/-1.2 [P>0.05] and for creatine phosphokinase 3.9+/-2.5, 6.4+/-3.7, 5.5+/-1.3, 5.5+/-0.8, P>0.05] IU xmin(-1) x g dry tissue(-1) in the reperfusion period, respectively) results as compared with the control group. 5. The addition of isocolloidoosmotic colloids to the cardioplegic solution did not appear to enhance the effectiveness of the crystalloid St. Thomas Hospital cardioplegic solution. If a colloid is to be chosen as a plasma replacer or an additive to priming solution in the preoperative period, or during open-heart surgery, it should be modified fluid gelatin-for no sign of cardiodepression was determined with the use of this agent.
摘要
  1. 心脏停搏液为在心脏不跳动状态下进行手术以及在心脏手术期间保护心脏免受缺血性损伤提供了机会。这些溶液的成分不断被调整,以努力找到最佳溶液。我们研究了胶体容量补充剂,如右旋糖酐、羟乙基淀粉和明胶,作为等胶体渗透压添加剂添加到圣托马斯医院心脏停搏液中对离体大鼠心脏缺血再灌注损伤的影响。2. 在对照组中,经过20分钟的稳定期后,用圣托马斯医院心脏停搏液使心脏停搏3分钟,然后进行30分钟的全心缺血。随后心脏再灌注10分钟。在实验组中,实验方案相同,但分别将羟乙基淀粉200/0.5(50克/升)、改良液体明胶(30克/升)或右旋糖酐70(25克/升)添加到圣托马斯医院溶液中。3. 比较所有心脏的缺血前和缺血后收缩性、心率、收缩率乘积、冠状动脉血流量、乳酸脱氢酶、肌酸磷酸激酶酶漏出以及湿/干重比。4. 所有组的收缩性(对于对照组、羟乙基淀粉组、明胶组和右旋糖酐组,再灌注第10分钟时的值分别为初始值的59±9%、56±11%、61±14%、49±14% [P均>0.05])和酶漏出情况(再灌注期乳酸脱氢酶分别为4.1±1.0、8.1±1.5、5.8±1.4、3.7±1.2 [P>0.05],肌酸磷酸激酶分别为3.9±2.5、6.4±3.7、5.5±1.3、5.5±0.8,P>0.05]国际单位×分钟(-1)×克干组织(-1))与对照组相比结果相似。5. 向心脏停搏液中添加等胶体渗透压胶体似乎并未增强晶体状圣托马斯医院心脏停搏液的有效性。如果要在术前或心脏直视手术期间选择一种胶体作为血浆代用品或预充液添加剂,应该选择改良液体明胶——因为使用这种制剂未发现心脏抑制的迹象。

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No beneficial effects of isocolloidoosmotic synthetic colloid addition to St. Thomas Hospital cardioplegic solution in ischemia-reperfusion injury in isolated perfused rat hearts.在离体灌注大鼠心脏的缺血再灌注损伤中,向圣托马斯医院心脏停搏液中添加等胶体渗透压合成胶体无有益作用。
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