异丙酚对犬急性心肌缺血再灌注损伤时血流动力学的影响  

Effects of propofol on hemodynamic of acute myocardial ischemia-reperfusion injury

作　　者：朱科明[1] 邓小明[1] 徐美英[1] 刘树孝[1] 

机构地区：[1]第二军医大学附属长海医院麻醉科,上海200433

出　　处：《中国急救医学》2001年第3期128-130,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的　研究不同剂量的异丙酚对犬急性心肌缺血再灌注损伤时血流动力学的影响。方法　杂种家犬 18只随机分为NS组 (生理盐水对照组 ,2ml·kg-1·h-1)、HP组 (高剂量异丙酚组 ,11 2mg·kg-1·h-1)和LP组 (低剂量异丙酚组 ,5 6mg·kg-1·h-1) ;开胸阻断左冠脉前降支 (LAD) 90min后再灌注 2 0 0min ,于注药前、注药 6 0min、阻断 90min以及再灌注 6 0min、12 0min和 180min时 ,分别测定和计算心率 (HR) ,体循环指标包括平均动脉压 (MAP)、中心静脉压 (CVP)、体循环阻力 (SVR) ,肺循环指标包括肺动脉压 (PAP)、肺动脉嵌压 (PCWP)和肺循环阻力 (PVR)、心排指数 (CI)。结果　缺血再灌注时HP和LP组的HR变化较小 ;体循环指标中除NS组MAP阻断后比阻断前降低 2 7% (P <0 0 5 ) ,其余变化不明显 ;缺血再灌注对肺循环的影响较大 ,但对NS组影响更大 ;再灌注 12 0min和 180min时HP组和LP组的心功能指标CI基本恢复阻断前水平 ,高于NS组同时间点的CI(P <0 0 5 )。结论　异丙酚对犬急性心肌缺血再灌注损伤时的心率有一定稳定作用 ,对体循环、肺循环和心功能有一定保护作用。Objective To evaluate the effects of propofol on hemodynamics of acute myocardial ischemia-reperfusion injury. Methods 18 hybrid dogs were divided randomly into NS group (Normal Saline, 2 ml·kg -1 ·h -1 ), HP group (High-dose Propofol, 11.2 mg·kg -1 ·h -1 ) and LP group (Low-dose Propofol, 5.6 mg·kg -1 ·h -1 ). These dogs were subjected to a 90-min left anterior descending coronary artery (LAD) occlusion followed by 200 min of reperfusion. Before administration, at 60-min after administration, at occlusion-90 min and reperfusion-60 min, -120 min, -180 min, the parameters of hemodynamics was assessed by measurement of HR, MAP, CVP, SVR, PAP, PCWP, PVR and CI.Results The change of HR caused by acute myocardial ischemia-reperfusion injury in HP and LP group was smaller than that in NS group. The values of MAP at occlusion-90 min decreased 27% compared with the baseline (P<0.05). The parameters of pulmonary circulation include PAP, PCWP and PVR increased obviously at occlusion-90 min and reperfusion-60 min, -120 min, -180 min. At 120-min and 180 min after reperfusion the values of CI in HP and LP group were similar to the values before occlusion, but significantly higher than those in NS group (P<0.05) at the same time.Conclusion Propofol can reduce the changes of HR, and protect the function of systemic circulation, pulmonary circulation and CI during acute myocardial ischemia-reperfusion injury in a canine model.

关 键 词：异丙酚 心肌缺血 再灌注损伤 血流动力学 犬 

分 类 号：R965[医药卫生—药理学]