机构地区:[1]山东中医药大学附属医院心内科,济南250011 [2]中国医学科学院阜外心血管病医院冠心病研究中心,北京100037
出 处:《疑难病杂志》2013年第4期253-256,共4页Chinese Journal of Difficult and Complicated Cases
基 金:国家自然科学基金项目(No.30500689)
摘 要:目的建立"心络绌急"动物模型,观察通心络对其预防作用。方法小型猪14头随机分为模型组、通心络组。模型组给予正常饲料的饮水通心络组动物喂服通心络胶囊超微粉0.5 g/kg 15 d。动物麻醉,左侧股动脉鞘管送入Pig导管测定左心室舒张末压(LVEDP)、左室最大压力(LVP_(max))、左室最低压力(LVP_(min),左室压力最大变化速率(dp/dt_(max))等血流动力学指标。右侧股动脉鞘管送入微导管,在前降支中段注射神经肽Y(NPY)3 nmol/3min。采用静脉心肌声学造影(MCE)在注射前,注射10、30 min测定微血管容积(α)、充填速率(β)和微循环血流量(MBF),同时记录心电图、BP、HR、LVEDP、LVP_(max)、LVP_(min)、dp/dt_(max)。在注射NPY前及注射后30 min,留取冠脉内血液标本2 ml,检测内皮素(ET-1)和一氧化氮(NO)水平。结果模型组小型猪4头,通心络组5头完成实验。(1)与注射前比较,模型组在10 min时SBP、DBP、HR升高(P<0.05,P<0.01),dp/dt_(max)下降(P<0.05),30 min后恢复至基线水平(P>0.05);心电图、LVEDP、LVP_(max)、LVP_(min)等没有明显变化(P>0.05)。通心络组10 min时血压升高(P<0.05),在30 min后恢复;心电图、HR、LVEDP、LVP_(max)、LVP_(min)、dp/dt_(max)等无明显变化(P>0.05)。(2)与注射前比较,模型组10 min时α、MBF降低(P<0.05,P<0.01),30 min时α降低(P<0.05)。通心络组10 min时α、β、MBF无明显变化(P>0.05),30 min时MBF明显升高(P<0.05)。2组10 min时△α、△MBF比较差异有统计学意义(P<0.05,P<0.01),在30 min,仅△α差异有统计学意义(P<0.01);(3)与治疗前比较模型组ET-1明显升高(P<0.05),通心络组无明显差异(P>0.05)。2组NO注射前后差异均无统计学意义(P>0.05)。结论小型猪冠脉前降支中段注射NPY,可建立"心络绌急"模型。通心络对NPY诱发的微血管痉挛有预防作用。Objective To establish animal model of"Xinluochuji"and observe the preventive effects of Tongxinluo. Methods 14 miniature pigs randomly divided into model group,Tongxinluo group,animals of Tongxinluo group fed superfine powder of Tongxinluo capsule in 0.5 k/kg for 15 days.The animal anaesthesia,the left sheath tube sends in the pig drive pipe,determines the left ventricle diastole end pressure(LVEDP) and left ventricular maximum pressure(LVP_(max)) and left ventricular lowest pressure(LVP_(min)),the ventricular pressure most sweeping change speed(dp/dt_(max)) and other hemodynamics targets.The right femoral artery sheath send into the micro catheter,in the middle of anterior descending branch injection of neuropeptide Y(NPY) 3 nmol/3 min.Using intravenous myocardial contrast echocardiography(MCE),Before injection, injection of 10,30 min to determine microvascular volume(α),filling rate(β) and microcirculation blood flow(MBF), Then simultaneously recorded ECG,BP,HR,LVEDP,LVP_(max),LVP_(min),dp/dt_(max).30 min after injection and prior to NPY injection, 2 ml blood samples were taken from coronary,endothelin-1(ET-1) and nitric oxide(NO) were detected.Results 4 miniature pigs in model group and 5 in Tongxinluo group completed the experiment.(1) In the model group SBP,DBP,HR increased(P0.05,P0.01 ),dp/dtmal decreased(P0.05 )in the 10 min,returned to baseline levels(P0.05 ) in the 30 min.ECG,LVEDP,LVP_(max),LVP_(min) had no significant change(P0.05 ).For Tongxinluo group,BP elevated (P0.05) after 10 min,recovered in the 30 min.ECG,HR,LVEDP,LVP_(max),LVP_(min),dp/dt_(max) had no significant change (P0.05 ).(2) Compared with the baseline value,in model group,αand MBF lowered in 10 min(P0.05,P0.01),a lowered in the 30 min(P0.05).In Tongxinluo group,α,β,MBF had no significant change(P0.05 ),at 10 min,ΔMBF,Δαincreased in 10 min and Act increased in 30 min in Tongxinluo group;(3)
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