GIK对急性缺血/再灌注犬心肌损伤的影响  

Effects of glucose-insulin-potassium on myocardial injury after ischemia/reperfusion in dogs

作　　者：何蓉[1] 姚德厚[1] 贾小兵[1] 陈璇[2] 李丹[3] 李源[4] 

机构地区：[1]成都军区机关医院内三科,成都610011 [2]成都军区疾病预防控制中心 [3]大连市中心医院心内科 [4]第四军医大学西京医院老年病科

出　　处：《西南国防医药》2011年第5期485-487,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的比较GIK(葡萄糖-胰岛素-钾)和GK(葡萄糖-钾)对犬在体急性心肌缺血/再灌注(MI/R)血液流变性和心肌损伤的影响,讨论胰岛素在GIK保护心肌缺血中的作用。方法采用定量缺血的方法制备犬急性MI/R模型,再灌注GIK、GK或生理盐水4 h后,抽取冠状静脉窦血,比较各组的红细胞压积(HCT)、全血高切粘度(ηbh)、全血低切粘度(ηbl)、血浆乳酸脱氢酶(LDH)、肌酸激酶CK)和梗死区面积的变化。结果 GIK组与另两组相比,再灌注后ηbh、ηbl、TK、HCT均有明显的改变(P<0.05)。GIK明显降低心肌梗死后LDH和CK活性(P<0.05),心肌梗死范围减少(P<0.05)。结论 GIK可改善MI/R犬血液流变学特性,降低全血黏度;减轻心肌损伤,显著地缩小急性心肌梗死范围,并减轻梗死程度,胰岛素是GIK中的关键成分。Objective To compare the effects of glucose-insulin-potassium（GIK）and glucose-potassium（GK）on hemorheological characteristics and myocardial injury after ischemia/perfusion in dogs in vivo,and to discuss the role of insulin in protecting ischemic myocardium.Methods Acute myocardial ischemia/perfusion（I/R）model of canine in vivo were prepared following a 50 min ischemia and 4 h reperfusion.They were treated with 0.9% normal saline,GIK（glucose： 50 g/L,insulin： 60 U/L,potassium： 80 mmol/L）and GK（glucose： 250 g/L,potassium： 80 mmol/L）during reperfusion,respectively.After that,blood samples from vena coronaria sinus were collected for the measurement of hemorheological indexes（HCT,ηbh,ηbl,etc.）and myocardial injury markers（LDH,CK）.The infarct size was compared among the three groups.Results Compared with normal saline and GK,canines treated with GIK showed lower ηbh and ηbl（P0.05）after 4 h perfusion;TK,HCT,LDH and CK activity in this group decreased significantly as well as the infarct size（P0.05）.Conclusion GIK can improve hemorheological parameters,lower whole blood viscosity,alleviate myocardial injury,and reduce acute myocardial infarct size and degree markedly.Insulin is a key component in GIK.

关 键 词：GIK 胰岛素 血液流变性 缺血/再灌注损伤 心肌 

分 类 号：R542.2[医药卫生—心血管疾病]