体外循环中去白细胞血再灌注对犬血流动力学影响.docVIP

体外循环中去白细胞血再灌注对犬血流动力学影响【中图分类号】R654.1【文献标识码】A【文章编号】1672－3783(2011)08－0031－01 【摘要】目的 研究犬体外循环（CPB）中去白细胞血再灌注对犬血流动力学的影响。方法 成年杂种犬18条，根据再灌注液成分不同随机分为对照组、全血组和去白细胞血组，每组6条。三组动物经麻醉和开胸后，建立体外循环心肌缺血再灌注模型。对照组在心肌缺血40min后，于主动脉根部以2ml/kg.min灌入晶体再灌注液，持续20min。全血组再灌注液为新鲜动脉全血，而去白细胞血组在再灌注通路中加用一次性白细胞滤过器（LDF），再灌注液为去白细胞新鲜动脉血，余均同对照组。去白细胞血组分别测定滤过前后血液成分的变化。分别于CPB前、阻断60min、开放30min和开放60min时,自心尖部取全层心肌分别进行髓过氧化物酶（MPO）活力、丙二醛（MDA）含量检测和线粒体分级，并于阻断前、开放30min及开放60min测定血液动力学指标。结果 滤后白细胞计数显著低于滤前；去白细胞血组在阻断60min、开放30min和和开放主动脉60min时心肌线粒体分级显著高于对照组和全血组，而MPO活性和MDA均显著低于对照组和全血组。去白细胞血组在开放30min和开放60min时血液动力学指标恢复较对照组和全血组迅速。结论 去白细胞血再灌注后左心室功能恢复迅速，从而对缺血心肌起到保护作用。 【关键词】 去白细胞血 心肌保护 体外循环 血液动力学 Canine hemodynamic changes during reperfusion with leukocyte-depleted blood in cardiopulmonary bypass. Liu En-yu1,FANG Hua2,3* 【Abstract】 Objective To investigate the alterations in hemodynamics with leukocyte-depleted blood reperfusion during cardiopulmonary bypass (CPB).Methods Eighteen adult healthy hybrid dogs of either sex weighting 12-18kg undergoing CPB, were randomized into 3 groups: the control group (group C,n=6),whole blood (group W,n=6) and the experimental group(group L ,n=6) with it use of the leukocyte depletion filter(LDF)on the bypass circuit.In group L,the hearts ,which were declamping(DC) after 60min aortic cross-clamping (AC), were continuously reperfused for 20min with leukocyte-depleted artery blood 2ml/kg by LDF connected with bypass circuit. Control group and group W were treated as group L but employing respectively physiological saline and artery blood as a substitute for leukocyte-depleted blood. The blood cells account before and after the filtration were measured. The level of myeloperoxidase（MPO）、malondialdehyde（MDA）and the ultrastructural changes of myocardium were determined before CPB、40min and 60min after AC、30min and 60min after DC. Hemodynamics were monitored before CPB、30min and 60min after DC.Results The white blood cell account decreased significantly after the filtration(P