纵隔阻滞对高脂血症兔冠状动脉粥样硬化形成及血液动力学的影响  

Effects of mediastinal block on coronary atherogenesis and hemodynamics in rabbits with hyperlipoidemia

作　　者：陈冀衡[1] 杨奕[2] 毕好生[3] 

机构地区：[1]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所麻醉科,100036 [2]北京大学临床肿瘤学院北京肿瘤医院暨北京市肿瘤防治研究所ICU,100036 [3]华中科技大学同济医学院附属同济医院麻醉学教研室

出　　处：《中华麻醉学杂志》2008年第3期231-233,共3页Chinese Journal of Anesthesiology

摘　　要：目的 探讨纵隔阻滞（MB）对高脂血症兔冠状动脉粥样硬化形成及血液动力学的影响。方法 健康雄性新西兰白兔48只，随机分为4组（n=12），对照组：普通饲料150g／d喂养16周；高脂组：高脂饲料150g／d喂养16周；胸段硬膜外阻滞（TEB）组：高脂饲料150g／d喂养16周，第13至16周行TEB（2％利多卡因2mg／kg，2次／日）；MB组：高脂饲料150g／d喂养16周，第13至16周MB（2％利多卡因2mg／kg，2次／日）。测定第一次阻滞前后的血液动力学指标，并于实验第1天和实验第4、8、12、16周测定血清总胆固醇（TC）、甘油三脂（TG）、高密度脂蛋白（HDL-C）、低密度脂蛋白（LDL-C）水平。实验第16周处死全部兔，光镜下评价心肌横断面肌间小动脉粥样硬化程度。结果 阻滞后TEB组MAP明显下降（P〈0．05），而MB组MAP维持稳定。与对照组比较，高脂组、TEB组及MB组血清TC、TG、LDL—C水平升高（P〈0．01或0．05）。与高脂组比较，TEB组及MB组心肌肌间小动脉粥样硬化率和内膜增厚率均明显降低（P〈0．01）；MB组与TEB组比较差异无统计学意义。结论 纵隔阻滞可抑制高脂血症兔冠状动脉粥样硬化的形成，其抑制程度与胸段硬膜外阻滞相似，而纵隔阻滞对血液动力学无明显影响。Objective To investigate the effects of mediastinal block （MB） on coronary atherogenesis and hemodynamics in rabbits with hypcrlipoidemia. Methods Forty-eight male New Zealand white rabbits were randomly divided into 4 groups （n = 12 each）： control group received normal diet 150 g/d for 16 weeks, hypercholesterol group received hypercholesterol diet 150 g/d for 16 weeks, thoracic epidurial block （TEB） group received hypercholesterol diet 150 g/d for 16 weeks and TEB was performed from 13th to 16th week with 2% lidocaine 2 mg/kg twice a day, and MB group received hypercholesterol diet 150 g/d for 16 weeks and MB was performed from 13th to 16th week with 2% lidocaine 2 mg/kg twice a day. MAP was measured before and after 1st block was performed. The serum levels of total cholesterol （ TC ）, triglyceride （ TG）, high density lipoprotein cholesterol （HDL-C） and low density lipoprotein cholesterol （LDL-C） were measured on 1 st day, and on 4th, 6th, 8th and 16th week during the experiment. At the end of 16 th week, all rabbits were killed by air embolism. Heart was removed and kept in 10% formalin for a week. The ventricles were transversely sectioned at the level of papillary muscle and slices from the cross section of the ventricles were obtained for determination of the degree of atherosclerosis by microscopy. Results MAP was decreased significantly after TEB in TEB group, while there was no significant changes in MAP after MB in MB group （P 〈 0.05） . The serum levels of TC, TG and LDL-C were significantly higher in hypereholesterol, TEB and MB groups than in control group （ P 〈 0.05 or 0.0l ）. The ratios of atherogenesis and intimal thickening were significantly lower in TEB and MB groups than in hypercholesterol group （ P 〈 0.01 ）, there was no significant difference between TEB and MB groups. Conclusion Mediastinal block can inhibit the development of coronary atherogenesis in rabbits with hyperlipoidemia to a great degree similar to that of thoracic epidural block,

关 键 词：纵隔 自主神经传导阻滞 高脂血症 冠状动脉硬化 血液动力学现象 

分 类 号：R614[医药卫生—麻醉学]