卡托普利和地尔硫卓对犬急性心肌缺血溶栓治疗的影响  

Effects of Captopril and Diltiazem on Thrombolysis in a Canine Model of Ischemia-Reperfusion

作　　者：成静[1] 盛净[1] 杜勤[1] 蔡文玮[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院老年科,上海200011

出　　处：《中国微循环》2006年第4期262-265,共4页Journal of Chinese Microcirculation

基　　金：上海市科委基金(024119124)

摘　　要：目的观察卡托普利和地尔硫卓对犬急性心肌梗死溶栓再灌注心肌损伤和纤溶凝血系统的影响。方法建立犬急性心肌缺血溶栓治疗的模型,溶栓同时应用卡托普利和地尔硫卓药物干预,测定治疗过程中组织型纤溶酶原激活物(t-PA)、组织型纤溶酶原抑制物(PAI)、血栓素(TXB2)、前列环素(6-酮-PGF1a)的含量和心肌酶谱等的动态变化。结果溶栓加用卡托普利治疗后,心肌损伤进一步减轻。溶栓后期t-PA活性无明显下降,PAI活性进一步减低,血浆TXB2均值降低,PGI2均值上升。溶栓加用地尔硫卓:血浆TXB2均值降低,PGI2均值上升。结论溶栓治疗时应用卡托普利可使再灌注心肌损伤进一步减轻,心肌梗死面积和范围减小;可以进一步改善纤溶-凝血功能障碍,升高t-PA和PGI2,降低PAI和TXB2,防治血栓形成对心肌缺血的进一步损害。地尔硫卓可以调节再灌注后PGI2/TXB2失衡,升高PGI2,降低TXB2,减轻血管痉挛和血栓形成,改善心肌缺血。Objective To observe the effects of captopril and dihiazem on thrombolysis in a canine model of ischemia-reperfution. Methods Ten healthy mongrel dogs were randomly divided into control, captopril and diltiazem groups. A canine model of ischemia-reperfusion was established. Plasma CK-MB, t-PA, PAI ,PGI2 ,TXB2were measured seven times. Results Comparing with the control group, the mean level of CK-MB was lower in the captopril group （P 〈 0.05）. The captopril group had a higher level of t-PA, antigen and lower PAI-1 compared with the control group （P 〈0.05）. A higher level of PGI2 and a lower TXB2 were measured both in the two drug groups （P 〈 0.05）. Conclusion Captopril may have more favorable effects on fibrinolysis and improve the coronary flow, relieve myocardial injury.

关 键 词：急性心肌缺血 溶栓治疗 血管紧张素转换酶抑制剂 钙拮抗剂 

分 类 号：R542.2[医药卫生—心血管疾病]