依那普利对犬急性右心室心肌梗死心源性休克血流动力学指标的作用  

Effects of Enalapril on hemodynamic indexes in cardiac shock dogs induced by acute right ventricular myocardial infarction

作　　者：富路[1] 谢荣盛[1] 黄明学[1] 李元十[1] 

机构地区：[1]哈尔滨医科大学第一临床医学院心内三科,哈尔滨150001

出　　处：《中华急诊医学杂志》2006年第10期899-901,共3页Chinese Journal of Emergency Medicine

基　　金：黑龙江省科技攻关项目(GC02C144-01)

摘　　要：目的观察依那普利、单纯补液对急性右心室心肌梗死(RVMI)心源性休克时血流动力学指标的作用。方法结扎犬冠状动脉造成大面积RVMI并发心源性休克模型。随机分为对照组、补液组、依那普利组。观察各组正常时、梗死后即刻及给药后即刻、1h、1周时点的平均动脉压(MAP)、心排血量(CO)、右心房压力(RAP)、右心室收缩压(RVSP)等血流动力学指标,并评价疗效。结果快速补液后,RAP进一步升高,加重了血流动力学变化。依那普利治疗后RAP降低,CO增加,血流动力学变化得以改善。结论大面积RVMI心源性休克时,快速扩容治疗在RAP≥13mmHg时会进一步损害左、右心室功能,依那普利可降低右心后负荷,增加CO,能有效纠正休克。Objective To study the therapeutic effects of Enalapril on hemodynamic indexes in cardiac shock dogs induced by acute right ventricular myocardial infarction （RVMI）. Methods Models of RVMI accompanied with cardiac shock were induced by ligating coronary artery. Dogs were randomly divided into three groups： control group, fluid replacement group and Enalapril group. The hemodynamic indexes including mean arterial pressure （MAP）, cardiac output （CO）, right atrial pressure （RAP） and right ventrieular systolic pressure （RVSP） were measured before and immediately after RVMI model establishment, and 1 hour and 1 week after the treatment. The therapeutic effects were evaluated. Results After rapid fluid replacement treatment, RAP became higher and the hemodynamics deteriorated. After Enalapril treatment, RAP decreased and CO increased. Conclusion When RVMI in large area oceurs, fluid replacement would further deteriorate the heart funetion of left and right ventrieles when RAP≥ 13 mmHg, and Enalapril fluid replacement would reduee the right ventriele load and improve shock.

关 键 词：心肌梗死 右心室 心源性休克 血流动力学 依那普利 

分 类 号：R542.22[医药卫生—心血管疾病]