尼可地尔对心肌缺血再灌注损害的作用

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1、【摘要】目的：观察KATP通道开放剂预处理对在体缺血再灌注(ischemia/reperfusion，I/R)心脏的影响。方法：建立在体大鼠心脏缺血再灌注模型。将60只大鼠随机分成4组：缺血再灌注(I/R)组，尼可地尔(NIC)组，KATP通道阻滞剂格列苯脲(GLI)+NIC组，GLI组。测定各组心肌梗塞范围，血清肌酸激酶(CK)，乳酸脱氢酶(LDH)浓度，监测各组心电图，应用透射电镜观察超微结构的变化。结果：与I/R组比较，NIC组心肌梗塞范围显著减小[(52.9±14.2)%∶(20.3±6.4)%，P<0.005]，血浆CK,LDH浓度

2、显著减少(P<0.05)，但并不能减少心律失常的发生;GLI+NIC组和GLI组与I/R组相比，心肌梗塞范围、血清CK、LDH浓度无显著性差异。结论：非特异性KATP通道开放剂尼可地尔有部分心肌保护作用，推测在缺血再灌注中发挥作用的KATP通道可能是对心电生理影响较小的亚型。【关键词】再灌注损伤;尼可地尔;格列苯脲Effectofnicorandil-KATPchannelopeneronischemia/reperfusioninmyocardiumofrat/ZHUJianfang，TIANLi，ZHUYuanzhou，CAOXu//

3、DepartmentofCardiology，UnionHospital，TongjiMedicalCollege，HuazhongUniversityofScienceandTechnology，Wuhan,Hubei,430022,China　　Correspondingauthor:ZHUYuanzhou，Email:yuanzhou.z@hotmail.com　　Abstract：Objective:Toinvestigatetheeffectofpretreatmentwithnicorandil(NTC)-KATPchanne

4、lopeneronischemia/reperfusion(I/R)ratinmyocardiumofrat.Methods:Thesnareforocclusionandreperfusionhadbeenputintotheanteriordescendingcoronaryarteryin60rats,whichweredividedintofourgroups:ischemia/reperfusion(I/R)group，nicorandil(NIC)group，glibenclamide(GLI),KATPchannelinhibi

5、tor+NICgroup，GLIgroup.Theactivityofcreatinekinaseandlactatedehydrogenaseinplasmaandtheinfarctsizeweremeasured.Theepisodeofarrhythmiaswasmonitored.Theultrastructuralchangesofthemyocardiumwereobservedunderelectronmicroscope.Results:ComparedwithI/Rgroup，theplasmaconcentrationo

6、fCKandLDHsignificantlyreduced(P<0.05all)，theinfarctsizesignificantlyreduced[(52.9±14.2)%vs.(20.3±6.4)%，P<0.005]buttheincidenceofmyocardialarrhythmiasnotsignificantlyreducedinnicorandilgroup,thesechangewerenosignificant/amongGLI+NICgroup,GLIgroupandI/Rgroup.Conclusion:Nicora

7、ndil-nonspecialKATPchannelopenermayhavepartofmyocardialprotectiveeffectofischemicpreconditioning.ItissuspectedthatoneoffamilyofKATPchannelplaysaprimaryroleinmyocardialprotectiveeffectofischemicpreconditioning.　　Keywords：Ischemic/injury;Nicorandil;Glibenclamide;Patassiumchan

8、nel　　尼可地尔，又名硝烟酯，作为硝酸酯类药物治疗心绞痛在临床上已得到广泛的应用，而作为KATP通道开放剂的作用却是近年来才被认识。在活体模型上，尼可地尔对缺血再