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热缺血20min猪心脏死亡供体心冠状动脉内皮功能的变化 预览

Effects of 20-minute warm ischemia on coronary endothelial function of pig donor hearts after cardiac death
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摘要 背景:心脏移植中,热缺血导致供心的损伤除了心肌损伤,还有冠状动脉血管内皮损伤,而冠状动脉血管内皮结构与功能的完整性是影响心脏移植患者术后近远期疗效的关键因素之一。目的:观察缺氧诱导的热缺血20 min猪心脏死亡供体供心冠状动脉内皮细胞功能变化。方法:健康瑞典家猪16头,随机分为对照组6头、心脏死亡供体组和心脏死亡供体+冷保存组各5头。对照组直接切取心脏冠状动脉左前降支远端血管环进行器官浴槽实验;心脏死亡供体组和心脏死亡供体+冷保存组均建立缺氧诱导的热缺血20 min的心脏死亡供体模型,心脏死亡供体组直接切取心脏冠状动脉左前降支远端血管环进行器官浴槽实验;心脏死亡供体+冷保存组切取心脏后保存4 h,再切取心脏冠状动脉左前降支远端血管环进行器官浴槽实验。评价3组冠状动脉内皮依赖性舒张(EDRmax)的变化。结果与结论:冠状动脉内皮依赖性舒张(EDRmax)3组间差异无显著性意义(P〉0.05);50%最大舒张时P物质的浓度对数(pE C50)3组间差异无显著性意义(P〉0.05)。提示热缺血20 min猪心脏死亡供体心脏冠状动脉内皮功能损伤不明显,心脏死亡供体+冷保存4 h对冠状动脉内皮功能也无显著影响。 BACKGROUND:Myocardial and coronary endothelial injury occurs in donor hearts due to warm ischemia during cardiac transplantation. Coronary endothelial structure and function play a critical role in long-term outcomes for patients after cardiac transplantation. OBJECTIVE:To study the effect of hypoxia-induced warm ischemia (20 minutes) on coronary endothelial function of porcine donor hearts after cardiac death (DCD). METHODS:Sixteen healthy Swedish domestic pigs were randomized into control (n=6), DCD (n=5), and DCD plus cold storage (n=5) groups, respectively. A DCD model in pigs was established using the method of hypoxia-induced 20-minute warm ischemia in the DCD and DCD plus cold storage groups. Isolation of the heart left anterior descending coronary artery or combined with heart preservation pretreatment for 4 hours was performed in the DCD and DCD plus cold storage groups. The maximum coronary endothelium-dependent relaxation was determined in the three groups. RESULTS AND CONCLUSION:There were no significant differences in the maximum coronary endothelium-dependent relaxation and the minus logarithmic of substance concentration induced 50%maximal relaxation among three groups (P〉0.05). These results indicate that 20-minute warm ischemia cannot lead to obvious coronary endothelial dysfunction. In addition, DCD combined with 4-hour cold storage does not affect coronary endothelial function.
作者 孙晓柯 张伟华 秦广启 廖秋明 Stig Steen 乔晨晖 Sun Xiao-ke, Zhang Wei-hua, Qin Guang-qi, Liao Qiu-ming, Stig Steen, Qiao Chen-hui (1Department of Cardiac Surgery, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China; 2Department of Cardiothoracic Surgery, Lund University Hospital, Sweden 22594)
出处 《中国组织工程研究》 CAS 北大核心 2016年第29期4362-4367,共6页 Journal of Clinical Rehabilitative Tissue Engineering Research
基金 河南省科技厅科技攻关项目(142102310346)
作者简介 孙晓柯,男,1982年生,河南省内乡县人,郑州大学在读硕士,主治医师,主要从事心脏外科基础与临床的研究。 通讯作者:乔晨晖,博士,主任医师,教授,郑州大学第一附属医院心外科,河南省郑州市450052
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