左西孟旦对离体鼠心再灌注性心律失常及心功能影响的对比研究  

Comparative study on the effects of levosimendan on the arrhythmia induced by reperfusion in isolated rat hearts

作　　者：李新巧[1] 刘金东[1] 曾因明[1] 

机构地区：[1]江苏省麻醉医学研究所,江苏徐州221002

出　　处：《徐州医学院学报》2008年第5期292-295,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的观察比较新型强心药钙增敏剂左西孟旦与传统强心药多巴酚丁胺对大鼠离体心脏缺血/再灌注后心律失常及心功能的影响。方法雄性SD大鼠32只,随机分为4组（n=8）：对照组（CON组）、左西孟旦组（LS组）、多巴酚丁胺组（DB组）和无水乙醇溶剂组（SOL组）。建立离体心脏缺血/再灌注损伤Langendorff灌注模型,平衡灌注20 min、缺血25 min、复灌120 min。复灌期分别灌注K-H液,含左西孟旦0.3μmol/L、多巴酚丁胺0.1μmol/L及无水乙醇0.6 mmol/L的K-H液120 min。观察比较各组心脏功能学指标;记录全程心电图,对各组心律失常发生情况进行评分,统计各组室性心动过速（VT）和心室纤颤（VF）发生率及其持续时间。结果在再灌注20-120 min,LS组和其他各组相比,左心室舒张末压（LVEDP）显著降低,左心室发展压（LVDP）和左心室内压变化最大速率（±dp/dtmax）显著增加（P〈0.05或P〈0.01）。再灌期LS组心律失常评分显著小于DB组（P〈0.01）,和CON组差异无显著性（P〉0.05）。DB组7例发生VT,3例发生VF,持续时间分别为VT（16.8±2.3）s及VF（9.6±1.9）s,而LS组无VT及VF发生。结论与传统强心剂多巴酚丁胺相比,左西孟旦显著改善大鼠缺血/再灌注后心功能,不加重再灌注性心律失常。Objective To compare the effects of levosimendan with that of dobutamine on the arrhythmia induced by reperfusion in isolated rat hearts. Methods 32 male isolated SD rat hearts were randomly divided into 4 groups ： control group （CON）, levosimendan group （LS）, dobutamine group （DB） and solvent group （SOL）. They were perfused on Langendorff apparatus for 20 min at 37℃ for equilibrium. Ischemia - reperfusion injury was produced after 25 min global ischemia and 120 min reperfusion. The respective perfusates were： K -H perfusate （for CON group） and K - H perfusates containing 0.3 μmol/L levosimendan （ for LS）, 0.1μmol/L dobutamine （ for DB ） and 0.6 mmol/L dehydrated alcohol （ for SOL）. The indexes of cardiac mechanical function, the arrhythmia score and the incidence and duration of VF and VT were studied. Results The LVEDP was lower and the LVDP and ± dp/dtmx were higher in LS group than in CON and DB groups （ P 〈 0.05 or P 〈 0.01 ）. The arrhythmia score in LS was lower than that in DB （ P 〈 0.01 ）. The incidence and durations of VT and VF were higher and longer in DB group than in LS group （P 〈0.01 ）. Conclusion Compared with dobutamine, levosimendan can better improve the functions of isolated rat hearts after isehemia - reperfusion, and in the same time, avoids or decreases the reperfusion induced arrhythmias.

关 键 词：左西孟旦 多巴酚丁胺 缺血/再灌注损伤 心律失常 大鼠 

分 类 号：R541[医药卫生—心血管疾病]