全氟碳化合物在离体心脏长时程低温保存中的作用

目的 研究全氟化碳化合物（PFC）在大鼠离体心脏长时程低温保存中的作用。方法 30只Wistar大鼠随机分为对照组（Celsior保存液）、Celsior 液通氧组（Celsior+O₂）、双层法通氧组（PFC/Celsior+O₂），每组10只。制备大鼠离体心脏Langendorff灌注模型。离体心脏在4 ℃条件下保存8 h，于复灌期分别检测血流动力学指标、冠脉流出量及磷酸肌酸激酶(CK) 、乳酸脱氢酶(LDH) 和天门冬氨酸转氨酶(AST)漏出量，观察心肌超微结构的改变。结果 心脏复灌后，与对照组和Celsior+O₂组比较，Celsior/PFC+O₂组左心室舒张压和左心室压力变化速率明显上升（P<0.01），LDH、CK和AST漏出量明显减少（P<0.01）；而Celsior+O₂组与对照组上述指标比较差异均无统计学意义（P>0.05）。超微结构观察发现，与对照组和Celsior+O2组比较，低温保存后PFC/Celsior+O₂组心肌纤维排列较整齐，肌浆网扩张、线粒体肿胀及嵴结构破坏程度均较轻。结论 氧合的PFC与常规心脏保存液联合应用能够通过向缺血心肌提供更多的氧来改善能量代谢，提高离体大鼠心脏长时程低温保存的效果。

Effects of perfluorochemical on in vitro long-term hypothermic heart preservation in rats

Objective To investigate the effects of perfluorochemical ( PFC) on in vitro long-term hypothermic heart preservation in rats. Methods Thirty Wistar rats were randomly divided into control group ( Celsior solution), Celsior + O_2 group (Celsior solution plus oxygen) and PFC/Celsior + O_2 group (two-layer method plus oxygen) , with 10 rats in each group. Langendorff model of isolated rat heart was prepared. The isolated heart was preserved at 4 ℃ for 8 h, and hemodynamic parameters, coronary effluent flow, and leakage of creatine kinase ( CK), lactate dehydrogenase ( LDH) and aspartate transaminase (AST) were detected after reperfusion. Besides, the myocardial ultrastructure was also observed. Results Compared with control group and Celsior + O_2 group, the left ventricular developed pressure and ± dp/dt in PFC/ Celsior + O_2 group significantly increased ( P < 0.01), while LDH, CK and AST leakage significantly decreased ( P < 0.01). However, there was no significant difference in the above paramters between Celsior + O_2 group and control group (P>0.05). Compared with control group and Celsior + O_2 group, the impairment of myocardial ultrastructure in PFC/ Celsior + O_2 group after hypothermic preservation was alleviated. Conclusion PFC as a supplementation to oxygen in heart preservation solution could enhance myocardial protection during in vitro long-term hypothermic heart preservation in rats via the improvement of energy metabolism.