心脏亚低温和缺血预处理对家兔急性心肌梗死的作用  

Study on the Protective Effects of Mild Hypothermia and Ischemia Precondition on AcuteMyocardial Infarction in Rabbits

作　　者：钱远宇[1] 孟庆义[1] 马勇[1] 王志忠[1] 

机构地区：[1]解放军总医院急诊科,100853

出　　处：《天津医药》2005年第4期229-231,共3页Tianjin Medical Journal

基　　金：教育部留学回国人员科研启动基金(2003)

摘　　要：目的:探讨心脏亚低温、心肌缺血预处理对家兔急性心肌梗死的保护作用。方法:21只家兔随机分为对照组、亚低温组和联合组(亚低温加缺血预处理)。结扎心脏冠状动脉前降支45min造成急性心肌梗死,然后再灌注2h。亚低温组和联合组通过物理降温使结扎30min时中心体温降到32℃～35℃;对照组体温维持在38℃～40℃。结果:心肌梗死后3组动物血压均出现下降,3组间差别无统计学意义。心肌梗死面积占缺血心肌面积的比例,亚低温组和联合组均明显低于对照组(P<0.05),联合组也低于亚低温组。亚低温组和联合组梗死后血清肌酸激酶同工酶(CK-MB)活力的升高均明显低于对照组(P<0.05)。结论:心脏亚低温可缩小家兔急性心肌梗死的面积,与心肌缺血预处理同时应用的保护效果可能会进一步加强。Objective: To study the protective effects of mild hypothermia and ischemia precondition on acute myocardial infarction in rabbits. Methods: Twenty-one rabbits were randomly divided into mild hypothermia group, union group (mild hypothermia add ischemia precondition) and control group. Each group underwent 45 minutes of left anterior descending coronary artery occlusion and 2 hours of reperfusion. Mild hypothermia group and union group were received ice cooling around the body and the core temperature were dropped to 32 ℃-35 ℃ after occluded for 30 minutes, while the body temperature were kept 38 ℃-40 ℃ in the control group. Results: The blood pressure became lower than before in all three groups after myocardial infarction, but there were no significant differences among them. Myocardial infarction area as a percentage of the ischemic area in mild hypothermia group and union group were lower than that in the control group, and the percentage of union group was also lower than that in the mild hypothermia group (P < 0.05).The elevations of the serum CK-MB level in mild hypothermia group and union group were significantlly lower than that in the control group (P < 0.05).Conclusion: Both body mild hypothermia and ischemia precondition may reduce infarct size on acute myocardial infarction in the rabbits, and their protective effects can be added to each other when used at the same time.

关 键 词：急性心肌梗死 亚低温 家兔 心脏 心肌缺血预处理 血清肌酸激酶同工酶 冠状动脉前降支 心肌梗死面积 对照组 保护作用 中心体温 物理降温 体温维持 缺血心肌 保护效果 再灌注 统计学 结扎 死后 

分 类 号：R542.22[医药卫生—心血管疾病] R651.15[医药卫生—内科学]