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題名 | Mycardial Functional Recovery and Metabolic Status in Isolated Reperfused Rabbit Heart: Effects of Glucose Concentration and Temperature on Cardioplegia=離體兔心再灌注的功能恢復及心肌代謝狀態:心臟麻痺時葡萄糖的濃度與溫度效應 |
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作者 | Ning,Xue-Han; Ding,Xinxin; Childs,Keith F.; Bolling,Steven; | 書刊名 | 慈濟醫學 |
卷期 | 7:4 1995.12[民84.12] |
頁次 | 頁243-260 |
分類號 | 415.31 |
關鍵詞 | 心肌缺血; 心肌代謝; 心臟麻痺; 低溫; 重灌注; 心肌pH; 乳酸; 二氧化碳; 腺苷; 組胺酸; Adenosine; ATP; Carbon dioxide; Cardioplegia; Contracture; Histidine; Hypothermia; Lactate; Myocardial ischemia; Myocardial metabolism; Myocardial pH; Reperfusion; |
語文 | 英文(English) |
中文摘要 | 為驗証 ,心臟麻痺時葡萄糖的有益效應隨其被代謝利用而改變這一假 設,對164只離體的灌注兔心,進行了34℃或4℃心臟麻痺 "缺血"實驗。以再灌 注後的左心室發展壓力 (DP)、dP/dmax、及心率DP乘積為 "缺血"前的值,來表 達功能恢復程度。當34℃"缺血"時,用含5.5、11、22、44、和88mM葡萄糖的心 臟麻痺液得到比1.4mM較好的功能恢復,22mM顯示最佳效應。隨後,22mM露醇 為滲透壓對照,與葡萄糖的效果做了比較。在34℃"缺血"120分鐘時,葡萄糖處 理組的乳酸(4.6±0.75mM*)和二氧化碳 (2.32±0.82mM*,*=P<0.05)水平,遠較甘 露醇組 (2.1±0.34mM 及 0.72±0.22m)為高;前者的心肌pH(6.14±0.26*)低於後 者 (6.77±0.24)。於15分鐘再灌注時,葡萄糖組的ATP含量 (10.12±0.70*μmol/g 乾重)高於甘露醇組 (1.85±1.00μmol/g乾重);前者再灌注時的左心室發展壓力 (64.2±16.1*)和dP/dtmax(63.5±13.2*)恢復程度,都還高於後者 (11.3±5.4及9.9± 4.6)。在4℃"缺血"時,再灌注的ATP水平和功能恢復於兩組間則無明顯差別。僅 用組胺酸或二氧化碳來降低心肌pH,無助於功能恢復。心室發展壓力的恢復與 心肌ATP水平呈良好相關 (R��=0.80)。結論:心肌麻痺時葡萄糖的有益作用依濃度 和溫度而變化;心肌ATP含量是一關鍵因素。(慈濟醫學1995;7:243-260) |
英文摘要 | To test the hypothesis that a beneficial effect of glucose in cardioplegia depends on metabolicutilization of glucose, 164 isolated, perfused rabbit hearts were subjected to 120 min ofcardioplegicischemia at 34 ℃ or 4 ℃. Functional recovery was reflected by left ventricular developed pressure (DP),dP/dtma and the product of heart rate and DP as ofpreischemic values during reperfusion. At 34℃ischemia, hearts treated with 5.5, 11, 22, 44, and 88 mM glucose showed significantly better functionalrecovery than those treated with O and 1.4 mM glucose, with 22 mM demonstrating optimal recovery.Subsequently, the effect of'22 mM glucose (GLU) was compared with 22 mM mannitol (MAN), used asan osmolar control. After 120 min of ischemia at 34℃, lactate and CO�� levels were 4.6±0.75 mM* and2.32± 0.82mM* in GLU and 2.1±0.34 mM and 0.97±0.22 mM in MAN and myocardial pH was lower inGLU (6.14±0.26*) than in MAN(6.77±0.24, *=p<0.05). At 15 min of reperfusion, myocardial ATP washigher in GLU than in MAN (10.12±0.70* vs 1.85±1.00 fMoUg dry tissue, respectively) and recovery ofleft ventricular developed pressure anddP/dtma was better in GLU(64.2±16.1* and 63.5±13.2*)than in MAN (11.3±5.4 and 9.9±4.6). However, during 4℃ ischemia both functional recovery andATP level showed no significant differences between GLU and MAN. Furthermore, improvements infunctional recovery were not observed when myocardial pH was only lowered by the addition ofhistidine or COy There was a good correlation between DP recovery and ATP level (R��=0.80). Inconclusion, the beneficial effect of 'glucose in cardioplegia is concentration and temperature-dependent;myocardial ATP concentration is a critical factor for functional recovery. (Tzu Chi Med J 1995;7:243-260) |
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