羊二尖瓣腱索和乳头肌切断对血液动力学和心收缩性的影响  

Effects of the Severed Mitral Chordae Tendineae and Papillary Muscle on Hemodynamic and Myocardial Contractility in Sheep

作　　者：陈建国[1] 何振成[1] 韩红[1] 侯钢星[1] 陈国友[1] 富维骏[1] 陈如坤[1] 陈龙[1] 孙道华[1] 徐志云[1] 赵玉华[1] 张琦[1] 俞可大 朱志年[1] 

机构地区：[1]第二军医大学基础医学部生理学教研室,第二军医大学长海医院胸外科,第二军医大学长海医院超声科,第二军医大学卫生勤务学系计算机教研室

出　　处：《第二军医大学学报》1994年第1期42-46,共5页Academic Journal of Second Military Medical University

基　　金：上海市自然科学基金

摘　　要：１４只健康、成年羊。分为４组：Ｃ组（对照）、Ｓ组（Ⅱ级腱索切断）、Ｆ组（Ⅰ级腱索切断）和Ｐ组（乳头肌切断）。观察腱索或乳头肌切断前、后，血波动力学和心收缩性的变化。实验发现：（１）羊对照组测定血液动力学数值与人类相近。（２）腱索或乳头肌切断后，ＬＶＰ、ＴｈＢＰ、ＡｏＢＦ、＋ｄｐ／ｄｔｍａｘ、Ｖｍａｘ和ＣＲＨＬ－Ｌｓ数值均呈显著下降；ＬＡＰ和ＰＡＰ显著增加。组间比较有显著性差异（Ｐ＜０．０１）。－ｄｐ／ｄｔｍａｘ和ＣＭＬ－Ｌｄ指标，在Ｆ组和Ｐ组呈显著性下降，在Ｓ组有２％～３％值增加。结果提示：（１）选用羊作为研究人类急性二尖瓣口返流（ＡＭＲ）的发生及其机理是合适的。（２）腱索或乳头肌切断后，出现血液动力学和心肌收缩性的变化与切断引发ＡＭＲ和冠脉灌住减少，并进而造成心泵功能下降有关。Experiments were performed on 14 healthy and adult sheep and were divided into 4 groups: C group(control), S group(severance of second chordae), F group(severance of first chordae) and P group(severance of papillary muscle). Hemodynamics, myocardial contractility and relaxation function were observed. The results were as follows: (1)The hemodynamic data of measurement in control sheep were closed to those in man; (2)The LVP, ThBP, AoBF, +dp/dtmax,Vmax and CRHL-Ls were decreased significantly after the severed CT or PM, while LAP and PAP were increased significantly. These changes were different significantly among S, F and P group (P<0.01). The -dp/dtmax and CRHL-Ld were decreased greatly in F and P group, while these indices were increased about 2%～3% slightly in S group. The results suggest that: (1) Choice of sheep was practicable to study occurrence of human AMR and its mechanism. (2) The changes of hemodynamics and myocardial contractility induced by severed CT or PM were related to decrease of cardial pump function which are due to occurrence of AMR and reduction of coronary perfusion.

关 键 词：二尖瓣 血液动力学 心肌收缩性 

分 类 号：R542.510.2[医药卫生—心血管疾病]