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目的探讨乳酸和氢饱和盐水能否减轻心肌细胞损伤。方法 72只SD大鼠随机分为假手术、缺血再灌注(R/I)、机械后适应(Post,再灌注/缺血时间为20/20 s×4)、乳酸(Lac,微量注射器心肌注射乳酸)、氢饱和盐水(Hyd,微量注射器心肌注射低剂量氢饱和盐水)和乳酸+氢饱和盐水组(Lac+Hyd,微量注射器心肌注射乳酸和低剂量氢饱和盐水)6组。测定再灌注3 min后右心房血浆pH值,处死大鼠取心肌组织测定MDA和SOD含量;另测定24 h后血流动力学、动脉血心肌酶含量和心肌梗死面积。结果 Lac+Hyd组再灌注后3 min右心房血浆pH值显著低于R/I组(7.32±0.06 vs.7.43±0.03,P<0.05),MDA含量显著低于R/I组[(1.14±0.16)nmol/mg pro vs.(1.56±0.21)nmol/mg pro,P<0.05],SOD含量高于R/I组[(57.92±15.12)U/mg pro vs.(35.48±12.46)U/mg pro,P<0.05]。再灌注24 h后,Lac+Hyd组CK[(579.00±223.61)U/L vs.(1268.52±211.53)U/L,P<0.05]和CK-MB[(392.94±166.25)U/L vs.(962.21±273.80)U/L,P<0.05]含量显著低于R/I组,心肌梗死面积比例显著低于R/I组(27.01%±6.56%vs.49.18%±8.52%,P<0.05)。以上指标均与Post组相比均无明显差异(P均>0.05)。Lac组和Hyd组CK和CK-MB含量显著低于R/I组,显著高于Post组Lac+Hyd组(P均<0.05),但心肌梗死面积比例同R/I组比较无统计学差异(P>0.05)。结论局部注射乳酸和氢饱和盐水可较好模拟机械后适应,有效减轻心肌细胞损伤。
Objective To investigate whether lactic acid and hydrogen-saturated saline can reduce myocardial cell injury. Methods Seventy-two SD rats were randomly divided into sham operation, ischemia / reperfusion (R / I), post-mechanical adaptation (Post, 20/20 s × 4 reperfusion / ischemia), lactic acid (Lactic acid injection), Hydrogen saturated saline (Hyd, microinjection of myocardium with low dose of saturated saline) and lactic acid + hydrogen saturation of saline group (Lac + Hyd, microinjection of lactic acid into myocardium and low dose of saturated saline). After 3 min of reperfusion, the pH value of right atrial plasma was measured. The myocardial tissues of rats were sacrificed to measure the contents of MDA and SOD. The hemodynamics, myocardial enzymes and myocardial infarction area were also measured 24 hours later. Results The pH value of right atrium in Lac + Hyd group was significantly lower than that in R / I group (7.32 ± 0.06 vs.7.43 ± 0.03, P <0.05) at 3 min after reperfusion, and the MDA content in Lac + Hyd group was significantly lower than that in R / I group [ (57.92 ± 15.12) U / mg pro vs. (35.48 ± 12.46) U / mg pro vs. (1.56 ± 0.21) nmol / mg pro and P <0.05) mg pro, P <0.05]. CK [(579.00 ± 223.61) U / L vs. (1268.52 ± 211.53) U / L, P <0.05] and CK-MB [(392.94 ± 166.25) U / L vs. (962.21 ± 273.80) U / L, P <0.05] was significantly lower than that in R / I group and the myocardial infarction area was significantly lower than that in R / I group (27.01% ± 6.56% vs.49.18% ± 8.52%, P <0.05 ). The above indicators were no significant difference compared with the Post group (P all> 0.05). The contents of CK and CK-MB in Lac group and Hyd group were significantly lower than those in R / I group and significantly higher than those in Post + Lac group (P <0.05). However, there was no significant difference in myocardial infarction area between R and I group (P> 0.05). Conclusion Local injection of lactic acid and hydrogen saturated saline can better simulate mechanical adaptation, effectively reduce myocardial cell injury.