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目的 探讨酸性复灌液对心肌局部肾素－血管紧张素系统（ＲＡＳ）的影响以及早期暂时性酸性液再灌对缺血－再灌注损伤保护的可能机制。方法 采用离体大鼠等容收缩心脏灌流模型，随机分为３组：１．正常对照组（Ｃ）；２．再灌对照组（Ｉ／Ｒ）；３．酸性液复灌组（Ａ）。用生理记录仪连续记录左室收缩末压（ＬＶＰＳＰ）、左室舒张末压（ＬＶＰＤＰ）、心室内压最大变化速率（±ｄｐ／ｄｔ ｍａｘ）、心率（ＨＲ）等；同时用生化和放免法测定不同时间点冠脉流出液中乳酸脱氢酶（ＬＤＨ）释放量、心肌组织中肾素血管紧张素转换酶（ＡＣＥ）活性、血管紧张素Ｉ（Ａｕｇ Ｉ）和血管紧张素 Ⅱ（Ａｕｇ Ⅱ）含量等指标。 结果 １．与Ｉ／Ｒ相比。 Ａ组ＡＣＥ活性和Ａｕｇ Ⅱ／Ａｕｇ Ⅰ转换率明显下降；２．Ａ组再灌初期未见心脏挛缩发生，心功能恢复率上升，最大ＬＶＰＤＰ降低，± ｄｐ／ｄｔ ｍａｘ升高。结论 心肌局部ＲＡＳ可能参与心肌缺血再灌注损伤的发生；早期应用暂时性偏酸液再灌对恢复心功能、防止心律失常的发生是有益的。
Objective To investigate the effect of acidic fluid on renin-angiotensin system (RAS) in myocardium and the possible mechanism of protection of ischemic-reperfusion injury by early transient acid liquid reperfusion. Methods The isolated rat isovolenic cardioplegia model was randomly divided into three groups: 1. Normal control group (C); 2. Reperfusion control group (I / R); 3. Acid liquid reperfusion group (A). Left ventricular end systolic pressure (LVPSP), left ventricular end-diastolic pressure (LVPDP), maximum ventricular pressure change rate (± dp / dt max) and heart rate (HR) The levels of lactate dehydrogenase (LDH), the activities of renin angiotensin converting enzyme (ACE), angiotensin I (Ang I) and angiotensin Ⅱ (Ang Ⅱ) in coronary effluent were measured at different time points. ) Content and other indicators. Results 1. Compared with I / R. A group of ACE activity and Aug Ⅱ / Aug Ⅰ conversion rate decreased significantly; 2. In the early stage of reperfusion, no cardiac contracture occurred in group A, heart function recovery rate increased, maximum LVPDP decreased and ± dp / dt max increased. Conclusions Myocardial local RAS may be involved in the occurrence of myocardial ischemia-reperfusion injury. Early application of partial acid-reperfusion may be beneficial in restoring cardiac function and preventing arrhythmia.