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1、卡维地洛对猪急性心肌梗死再灌注后无再流的影响作者:赵京林,杨跃进,荆志成,吴永建,尤士杰,杨伟宪,孟亮,田毅,陈纪林,高润林,陈在嘉【关键词】急性心肌梗死Beneficialeffectsofcarvedilolonmyocardialnorefloinisodelsofacutemyocardialinfarctionandreperfusion ZHAOJingLin,YANGYueJin,JINGZhiCheng,ENGLiang,TIANYi,CHENJiLin,GAORunLin,CHEN
2、ZaiJia DepartmentofCardiovasology,CardiovascularInstitute,FuyofMedicalSciencesandPekingUnionMedicalCollege,BEIjing100037,China 【Abstract】AIM:Toevaluatetheeffectsofcarvedilol(betablocker)onmyocardialnorefloinisodelofacutemyocardialinfarction(AMI)andrep
3、erfusion.METHODS:Tinisizedinto3groups:control,carvediloltreatment[1mg/(kg・d)]andshamoperationgroups(n=8).Animalsintheformer2groupsinofreperfusion.Dataonhemodynamicsandcoronarybloodfloe(CBV)yocardialcontrastechocardiography(MCE)invivoandpathologic
4、almeans.Necrosisarea(NA)easuredchloride(TTC)staining.RESULTS:①Incontrolgroup,leftventricularsystolicpressure(LVSP),maximalrateofincreaseanddeclineinleftventricularpressure(±dp/dtmax)andcardiacoutput(CO)significantlydeclined(P<0.05),onarycapillaryaxfu
5、rthersignificantlydeclined(P<0.05)at60minofreperfusion.Incarvedilolgroup,thechangesofLVSP,±dp/dtmax,COandLVEDPeasthoseinthecontrolgroupafter3hofAMI.Incontrast,LVSP,±dp/dtmax,CO,LVEDPandpulmonarycapillaryinofreperfusion.②Incontrolgroup,thecoronaryliga
6、tionareas(LA)ilar(P>0.05)onbothMCEinvivoandpathologicalevaluationandANRilarashighas78.5%and82.3%respectively,ethodsmediatelyafterreleaseofocclusion(3h)andat60minofreperfusion(bothP<0.01).Incarvediloltreatedgroup,CBVmediatelyafterreleaseofocclusion
7、(3h)andat60minofreperfusion(bothP<0.05),thoughsignificantlyincreasedto70.6%and74.1%ofthebaseline,yocardialnorefloprovingleftventricularfunctionandreducinginfarctareaduringAMIandreperfusioninminisyocardialinfarction;sg/(kg・d)和假手术组,每组8只.冠状动脉结扎3h
8、,松解1h制备AMI再灌注模型.AMI前、后和再灌注后均行血流动力学测定和心肌声学造影(MCE)检查,最终行病理学分析.结果:①与AMI前相比,对照组AMI后3h主动脉收缩和舒张压(SBP和DBP)、左室收缩压(LVSP),心排量(CO)和左心室内压最大收缩和舒张变化速率(±dp/dtmax)均显著下降(P<0.05),肺毛细血管楔压(PCI后3h各项指标变化与对照组相同;但再灌注后1hLVSP,LVEDP,±dp/dtmax和CO均显著恢复(P&