CritCareMed2011Oct;[IF:6.254]
Transfusionoffreshbutnotoldstoredbloodreducesinfarctsizeandimprovescardiacfunctionafteracutemyocardialinfarctioninanemicrats.
HuH,XenocostasA,Chin-YeeN,LuX,Chin-YeeI,FengQ.
FromtheCentreforCriticalIllness,LawsonResearchHealthResearchInstitute(AX,HH,XL,ICY,QF),CanADIanBloodServices(ICY),andDepartmentsofMedicine(AX,HH,ICY,QF)andPhysiologyandPharmacology(QF),UniversityofWesternOntario,London,Ontario,Canada;NorthSichuanMedicalCollegeFirstAffiliatedHospital(HH),Nanchong,Sichuan,P.R.China.
四川川北医学院附属第一医院，加拿大安大略省西安大略大学，
加拿大血液服务和生理学和药理学部门，劳森卫生研究院中心

Abstract
OBJECTIVES::Werecentlydemonstratedthattransfusionoffreshbloodto100g/Lhemoglobininanemicanimalsofferscardioprotectionafteracutemyocardialinfarction.Theobjectiveofthisstudywastocomparethecardioprotectiveeffectsoffreshvs.storedbloodwhentransfusedinanemicratsafteracutemyocardialinfarction.STUDYDESIGN::Randomizedanimalstudy.SETTING::Universitylaboratory.SUBJECTS::MaleSprague-Dawleyratsweighing200-300g.INTERVENTION::Myocardialinfarctionwasinducedbycoronaryarteryligationin49maleSprague-Dawleyratsweighing200-300g,38ofwhichwereanemic(80-90g/L)and11withnormalhemoglobinlevels.Anemicanimalswererandomizedtoreceivefreshblood(within4hrs),storedblood(7days),ornotransfusionimmediatelyaftermyocardialinfarction.MEASUREMENTSANDMAINRESULTS::At24hrsaftermyocardialinfarction,cardiacfunction,infarctsize,andapoptosisweredetermined.ErythrocyteATP,2,3-DPG,hemoglobin,andfreehemoglobinlevelsinthesupernatantweredetermined.Transfusionwithfreshbutnotstoredbloodsignificantlydecreasedinfarctsizeandmyocardialapoptosisinanemicratswhencomparedtoanemicanimalsnotundergoingtransfusion.Cardiacfunctionandsurvivalweresignificantlyimprovedintheanemicanimalsundergoingfreshbloodtransfusioncomparedtocontrolanemicanimals.AnalysisofstoredredbloodcellsshowedreductionsofintracellularATPand2,3-DPGlevelsandfreehemoglobinwasincreasedinthesupernatant.CONCLUSIONS::Theprolongedstorageofbloodnegatesthebeneficialeffectsoffreshbloodtransfusion,whichincludereductionsininfarctsizeandmyocardialapoptosis,andimprovementsincardiacfunctionandshort-termsurvivalafteracutemyocardialinfarctioninthisanimalmodel.

摘要
目的：我们最近证明向贫血的动物输新鲜血到100g/L血红蛋白在心肌梗死后能提供心脏保护。
这项研究的目的是对比贫血小鼠心肌梗死后输入新鲜血VS.库存血的心脏保护作用。
实验设计：随机动物研究。环境：大学实验室。实验对象：200-300g.Sprague-Dawley小鼠
干预：冠状动脉结扎诱导49只重200-300g的Sprague-Dawley小鼠心肌梗死，38只贫血(80-90g/L)，11只正常。贫血小鼠被随机接受新鲜血液（4小时内），库存血（7天），或梗死后不输血。
测定与主要结果：测定心肌梗死24小时后的心脏功能，梗死尺寸，细胞凋亡。
测定上清液红细胞ATP，2,3-DPG,血红蛋白，游离血红蛋白水平。
与没有输血的贫血小鼠相比，输了新鲜血而非库存血的贫血小鼠的心肌梗死尺寸以及细胞凋亡显著减少。
输入了新鲜血的贫血小鼠的心脏功能和存活比对照贫血小鼠显著改善。
库存血红细胞分析显示：上清液中细胞内ATP，2、3—DPG水平和游离血红蛋白显著减少。
结论：长期库存血可以抵消输入新鲜血的有益效果，包括：减少梗死尺寸和细胞凋亡以及可以改善心脏功能和急性心肌梗死后短期存活。