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实验性缺血再灌注心肌顿抑与一氧化氮的关系及东莨菪碱对其影响 |
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Relationship between myocardial stunning and nitric oxide (NO) after experimen-tal
ischemia/reperfusion and the beneficial effect of scopolamine
朱洪生 黄忠耀 崔世涛 张有荣 卢蓉 吴学军 张谷兰
Zhu Hongsheng, Huang Zhongyao, Cui Shitao, et al
【摘要】 目的 探讨体外循环缺血再灌注心肌顿抑与心肌一氧化氮(NO)产生之
间的关系及东莨菪碱对其影响。方法 12只绵羊，随机均分为：对照组和实验组：
即东莨菪碱治疗组。常规建立体外循环，对照组主动脉阻断同时灌注冷停搏液(本
院配方)；实验组，停搏液中加入东莨菪碱17.5 μg/kg。于主动脉阻断前、再灌
注5分钟、再灌注30分钟取冠状窦血检测NO、肌酸激酶(CK)、环磷酸鸟苷(cGMP)
浓度，取心肌测定丙二醛(MDA)含量，相应时点监测心功能。结果 再灌注5分
钟和30分钟时，对照组心肌血的NO、CK、cGMP、MDA均明显升高，与主动脉阻断
前相比差异有显著性(P〈0.05或〈0.001)，和实验组相同时间点相比差异有显著性
(P<0.05或〈0.01)。两组再灌注5分钟和30分钟时心肌功能均降低，对照组较实
验组更为显著。再灌注后NO的变化与心肌MDA和CK之间呈正相关(P〈0.05和0.01)。
结论 缺血再灌注心肌顿抑与NO产生增加有关，大量释放的NO提高心肌组织cGMP，
参与心肌细胞脂质过氧化损害心肌功能。东莨菪碱减少NO产生、保护顿抑心肌的
作用可能与其抗脂质过氧化有关。
【关键词】 心肌顿抑 一氧化氮 东莨菪碱
Relationship between myocardial stunning and nitric oxide (NO) after experimental
ischemia/reperfusion and the beneficial effect of scopolamine Zhu Hongsheng, Huang
Zhongyao, Cui Shitao, et al. Department of Cardiothoracic Surgery of Renji Hospital, Shanghai
Second Medical University, Shanghai 200001
【Abstract】 Objective Studies on alterations of the production of myocardial nitric oxide
(NO) during ischemia/reperfusion were carried out. The relationship between myocardial stunning
and NO was observed on 12 sheep divided randomly into two groups: control (Ⅰ, n=6) and
scopolamine treated (Ⅱ, n=6). Methods Cardiopulmonary bypass (CPB) was instituted routinely
and cold cardioplegic solution was administered into the root of aorta. In group I, Renji solution
was infused and in group Ⅱ scopolamine (17.5 μg/kg) was added into Renji solution. Blood
samples were taken from coronary sinus before aortic crossclamping (A), 5 min(B) and 30 min
(C) after reperfusion. Parameters including NO, CK, cGMP were measured. Specimens of myocardiu
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