心脏停跳液(器官保存液)最初是为了保护在心脏外科手术(心脏移植手术)中的心肌(心肌细胞)而设计的.由于心肌细胞和血管细胞(内皮细胞和平滑肌细胞)在结构和功能上的差异,此类液体对冠脉的血管细胞有不利的作用.同时,这种不利的作用往往由于许多其他的因素而变得复杂化,例如缺血再灌注、温度、灌注压或者灌注持续时间.在评估一种停跳液对冠脉内皮功能的影响时,我们需要考虑很多方面.第一,需要确定停跳液对内皮的整体影响.第二,必须区分停跳液对每种血管内皮细胞舒张因子(一氧化氮,前列环素,内皮源性超极化因子)的作用.第三,需要研究停跳液里各个主要成分的作用.最后,需要研究各种新型添加剂的作用.在过去十余年中,我们的研究集中在心脏外科手术中内皮细胞的功能上并首次发现了高钾对内皮细胞超极化因子的损害作用.本综述拟在现有文献基础上讨论以上的问题,希望能够为心脏停跳液或器官保存液更进一步的发展提供信息.%Cardioplegic (and organ preservation) solutions were initially designed to protect the myocardium (cardiac myocytes) during cardiac surgery (and heart transplantation). Due to the differences between the cardiac myocytes and vascular (endothelial and smooth muscle) cells in structure and function, the solutions may have adverse effect on coronary vascular cells. However, such effect is often complicated by many other factors such as ischemiareperfusion injury, temperature, and perfusion pressure or duration. In evaluation of the effect of a solution on the coronary endothelial function, a number of points should be taken into consideration. First, the overall effect on endothelium should be identified. Second, the effect of the solution on the individual endothelium-derived relaxing factors (nitric oxide, prostacylin, and endothelium-derived hyperpolarizing factor) must be distinguished. Third, the effect of each major component of the solution should be investigated. Fourth, the effect of a variety of new additives in the solution may be studied. In the last decades, we have focused our research on the endothelial function during open heart surgery and have for the first time found that high potassium concentration impairs the EDHF-mediated function. This review attempts to discuss the above issues based on available literature in order to provide information for further development of cardioplegic or organ preservation solutions.
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