【 摘要】 目的 观察含4.6μmol/L卡托普利的停搏液及再灌注血液对低温体外循环下犬在体心脏的心肌保护作用。方法 16只杂种犬随机分为A组：对照组及B组：卡托普利组。A组仅用St.Thomas改型停搏液，B组采用含有4.6μmol/LCpl的St.Thomas改型停搏液及再灌注血液。测定血流动力学参数、冠状静脉窦血清肌酸激酶(CK)及肌酸激酶同工酶(CK-MB)浓度、心肌组织丙二醛(MDA)、K⁺ 、Na⁺ 、Ca²⁺ 及水含量。结果 心脏复跳后，B组主动脉血流量、冠状动脉血流量、±dp/dt_max 恢复百分率高于对照组(P<0.05)，而冠状静脉窦血CK及CK-MB，心肌组织MDA、Na⁺ 、Ca²⁺ 及水含量则低于对照组(P<0.01)。结论 卡托普利可通过改善冠脉循环、清除氧自由基及减轻钙超载等作用保护心肌。

    Myocardial protective effect of captopril on the ischemia andreperfusion injury in canine heart Luo Ailun, GuoXiangyang, Xu Shouchun, et al. Department of Anesthesia, Peking Union Medical CollegeHospital, CAMS and PUMC, Beijing 100730

     【Abstract 】 Objective To investigate themyocardial protective effects of cardioplegic solution and reperfusional blood containing4.6 μmol/L captopril (Cpl) on the canine heart underhypothermic extracorporeal circulation.Methods Sixteenmongrel dogs were randomly divided into control and Cpl groups. In the control group, onlymodified St. Thomas cardioplegia was used, and in the Cpl group, St. Thomas cardioplegicsolution and reperfusional blood containing 4.6 μmol/LCpl were used. The hemodynamics, concentrations of CK and CK-MB in the coronary sinusblood, and the contents of malonyldialdehyde (MDA) ), K⁺ ,Na⁺ ,Ca²⁺ and water in the myocardium were determined. Results Afterischemia and reperfusion, the recovery percentages of aortic flow, coronary blood flow,and ±dp/dtmax in the Cpl group were significantly higher than those in the control group(P<0.05 or P<0.01), while the concentrations of CK and CK-MB in the coronary sinusblood, and the contents of MDA, Ca²⁺ , Na⁺ , and water in themyocardium of the Cpl group were significantly lower than those of the control group(P<0.01).Conclusion Captopril can protect themyocardium against ischemia and reperfusion injury by ameliorating coronary circulation,scavenging oxygen free radicals and alleviating Ca²⁺ overload.

     【Key words 】 captopril myocardium ischemia-reperfusion injury

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