普罗帕酮、普鲁卡因胺、美托洛尔及其联合用药预防实验性再灌注室性心律失常的评价  

ASSESSMENT OF PROPAFENONE, METOPROLOL, PROCAINAMIDE, AND ITS COMBINATION TO PREVENT REPERFUSION VF IN ISCHEMIA/REPERFUSION PORCINE MODEL

作　　者：刘忠豫[1] 庄亚纯[1] 顾菊康[1] 顾逸敏[1] 庄文燕[1] 江智文[1] 颜和昌[1] 

机构地区：[1]上海市第一人民医院

出　　处：《中国循环杂志》1993年第11期667-669,共3页Chinese Circulation Journal

摘　　要：以闭胸式冠状动脉缺血—再灌注实验模型,探讨普罗帕酮(Ic)、美托洛尔(Ⅱ)、普鲁卡因胺(Ia)及其联合用药对实验性再灌注心律失常的预防价值。85头猪分为7组:①对照组;②普罗帕酮(1 mg/kg);③美托洛尔(4 mg/kg);④普罗帕酮+美托洛尔;⑤普鲁卡因胺(20 mg/kg为冲击量,0.1mg·kg^(-1)/min为维持量);⑥普鲁卡因胺+美托洛尔;⑦普罗帕酮+普鲁卡因胺。除对照组为13头猪外,其余各组均为12头。实验结果:①单剂美托洛尔(1/12比7/13,P<0.05)和美托洛尔、普罗帕酮联合(0/12比7/13,P<0.02),有明显降低猪再灌注心室颤动的作用。②普鲁卡因胺和普罗帕酮联合仅发生2例再灌注心室颤动。③各组均未能制止再灌注持续室性心动过速和缺血性心室颤动。In experimental ischemia/reperfusion porcine model, the development of ventricular fibrillation (VF) after reperfusion is very difficult to prevent by pre-treatment with anti-arrhythmic agent. In the present study, we tested propafenone, procainamide, metoprolol and its combination to prevent reperfusion VF. The hypothesis is that combined drug therapy may have greater anti-VF efficacy than either alone The proximal LAD was occluded for twenty minutes by intra-coronary balloon inflation. Drug prophylaxis was initated 20 minutes prior to LAD occlusion in each group. In 85 close chest anesthetized pigs, divided into seven groups, ①control, ②propafenone (1 mg/kg). ③metoprolol (4 mg/kg), ④combined propafenone and metoprolol, ⑤proeainamide (20 mg/kg iv within 2 min as initial dose follwed by 0.1 mg/kg/min as a maintenance dose over the entire experiment), ⑥combined procainamide and metoprolol, ⑦combined procainamide and propafenone with 12 pigs in each group except the control (n=13). Significant protection against reperfusion VF occurred only in group 2 (metoprolol) and group 4 (propafenone+metoprolol). In comparing with control, propafenone with metoprolol was found to be more effective in anti VF (0/12 vs 7/ 13, p<0.02) than the group of Metoprolol (1/12 vs 7/13, p<0.05) alone. Only 2 cases of reperfusion VF occurred in group 7 (propafenone with proeainamide).

关 键 词：再灌注 心室颤动 缺血性 

分 类 号：R541.7[医药卫生—心血管疾病]