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目的 判断全身亚低温治疗的心脏效应及其临床使用的安全性。方法 5 8只Wistar大鼠随机分成假手术组 (Ⅰ组 ,n =10 )、脑梗死常温组 (Ⅱ组 ,n =2 4 )和脑梗死亚低温组 (Ⅲ组 ,n =2 4 ) ,采用线栓法制作大脑中动脉 (MCA)梗死模型。测定术后 12h的心肌高能磷酸化合物 (ATP、ADP和AMP)及能量储备(EC)值 ,动态监测梗死组的异常ECG发生率 ,观察心肌的超微结构改变。结果 缺血后 12h时Ⅱ和Ⅲ组鼠心肌的ATP、ADP及EC均较Ⅰ组下降 (P <0 .0 1) ,但Ⅲ组ATP及EC较Ⅱ组增高 (P <0 .0 1) ;缺血后Ⅲ组鼠心率 (HR)较Ⅱ组明显降低 (P <0 .0 1) ,Ⅲ组异常ECG发生率与Ⅱ组比较无明显差异 ;超微结构显示Ⅱ和Ⅲ组结构均较Ⅰ组差 ,但Ⅲ组优于Ⅱ组。结论 全身亚低温治疗在一定程度上改善了因应激性缺血而下降的心肌能量储备及缺血对心肌超微结构的影响 ,且不产生严重的心电生理异常 ,其临床使用是安全的。
Objective To determine the cardiac effect of systemic hypothermia and the safety of its clinical use. Methods Fifty eight Wistar rats were randomly divided into sham operation group (group Ⅰ, n = 10), normal temperature group (group Ⅱ, n = 24) and mild hypothermia group (group Ⅲ, n = 24) The middle cerebral artery (MCA) infarction model was made by using thread method. The levels of myocardial ATP, ADP and AMP and energy reserve (EC) were measured at 12h postoperatively. The incidence of abnormal ECG in the infarction group was dynamically monitored and the myocardial ultrastructure was observed. Results The levels of ATP, ADP and EC in group Ⅱ and group Ⅲ were significantly decreased at 12 h after ischemia (P <0.01), but the levels of ATP and EC in group Ⅲ were higher than those in group Ⅱ (P <0.01) (P <0.01). The incidence of abnormal ECG in group Ⅲ was no significant difference compared with that in group Ⅱ. The ultrastructure showed that the structure of group Ⅱ and Ⅲ were significantly lower than that in group Ⅱ Group Ⅰ was worse, but group Ⅲ was better than group Ⅱ. Conclusion The whole body hypothermia therapy can improve the myocardial energy reserve and ischemic damage to myocardial ultrastructure induced by stress ischemia to a certain extent, and does not produce serious electrophysiological abnormalities. Its clinical use is safe.