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目的探讨小肠缺血预处理和急性等容性血液稀释对缺血心肌的保护作用。方法 18只新西兰大白兔作心肌缺血造模,分别行缺血再灌注(Ⅰ组)、小肠缺血预处理(Ⅱ组)和小肠缺血预处理+血液稀释(Ⅲ组)。监测HR和MAP,血浆CK、CK-MB、LDH、CTnI及心梗面积,并在电镜下观察心肌细胞结构的改变。结果 (1)肠系膜上动脉阻断期间,Ⅱ、Ⅲ组HR、BP低于Ⅰ组(P<0.05)。(2)Ⅱ、Ⅲ组的CK、CK-MB、LDH及CTnI值低于Ⅰ组(P<0.05)。(3)Ⅱ、Ⅲ组的心梗面积小于Ⅰ组(P<0.05)。(4)电镜下,Ⅱ、Ⅲ组细胞损伤轻于Ⅰ组。结论小肠缺血预处理能减少心肌缺血再灌注损伤,急性等容性血液稀释不会减弱前者的保护作用。
Objective To investigate the protective effect of ischemic preconditioning and acute isobaric hemodilution on ischemic myocardium. Methods Eighteen New Zealand white rabbits were used for myocardial ischemia. The rats were subjected to ischemia reperfusion (group Ⅰ), small intestine ischemia preconditioning (group Ⅱ) and intestinal preconditioning + hemodilution (group Ⅲ) respectively. The HR and MAP, plasma CK, CK-MB, LDH, CTnI and myocardial infarction area were monitored. The changes of myocardial cell structure were observed under electron microscope. Results (1) During the period of superior mesenteric artery occlusion, HR and BP in group Ⅱ and Ⅲ were lower than those in group Ⅰ (P <0.05). (2) CK, CK-MB, LDH and CTnI in group Ⅱ and Ⅲ were lower than those in group Ⅰ (P <0.05). (3) The infarct size in group Ⅱ and Ⅲ was smaller than that in group Ⅰ (P <0.05). (4) Electron microscope, Ⅱ, Ⅲ group cell damage lighter than the group Ⅰ. Conclusions Small intestinal ischemia preconditioning can reduce myocardial ischemia-reperfusion injury. Acute isoproterenol-induced hemodilution does not reduce the protective effect of the former.