洋地黄对小型猪急性心肌梗死合并急性心力衰竭后左室重塑的影响  

Effect of digitalis on left ventricular remodeling after microswine with acute heart failue after acute myocardial infarction

作　　者：黄军[1,2] 顾晓龙[2] 董正华[2] 雷辉燕[3] 龚志华[2] 向定成[2] 

机构地区：[1]南方医科大学研究生学院,广东广州510515 [2]广州军区广州总医院心血管内科,广东广州510010 [3]广州军区广州总医院超声影像科,广东广州510010

出　　处：《中国生化药物杂志》2015年第2期21-23,27,共4页Chinese Journal of Biochemical Pharmaceutics

摘　　要：目的探讨洋地黄在小型猪急性心肌梗死(acute myocardial infarction,AMI)合并急性心力衰竭后左室重塑的应用价值。方法应用球囊封堵法建立小型猪AMI合并急性心衰模型(n=8),再灌注后随机分为洋地黄组(n=4)和对照组(n=4),分别在建模后给予西地兰(0.025 mg/kg)和单纯生理盐水静注,次日洋地黄组加用地高辛0.125 mg/d治疗。超声测量2组左室容积、不同区域室壁厚度及室壁增厚率的变化,分别于AMI后7 d和1 m后处死,取心脏测量梗死面积。结果造模后2组小型猪左室容积均增大、室壁变薄,与造模前比较差异均有统计学意义(P<0.05,P<0.01);洋地黄组用药后1、2、3 h左室容积缩小、室壁呈增厚趋势,但至7 d后2组左室容积明显增大,梗死区室壁明显变薄、局部增厚率明显降低,与用药后1、2、3 h比较差异有统计学意义(P<0.05,P<0.01);而交界区及正常区代偿性增厚,但室壁增厚率各时间点无明显差异。2组小型猪梗死面积比较差异无统计学意义。结论AMI合并心衰动物模型上早期使用洋地黄可以显著改善血液动力学效应,但对梗死面积和近期左室重塑无明显影响。Objective To explore application value of digitalis on left ventficular remodeling in microswine with acute heart failure after acute myocardial infarction （AMI）. Methods Animal models of acute heart failure after AMI were developed by inflating a balloon in left anterior descending artery in 8 microswines. And those animals were randomly divided into digitalis group （n = 4） and control group （n = 4 ） after reperfusion by deflating the balloon. A dose of Lanatoside C（0. 025 mg/kg） or the equivalent volume of saline was intravenously injected after model establishment in digitalis group and control group respectively, followed by digoxin 0. 125 mg/d in digitalis group. The changes of left ventricular volume, the thickness of ventricular walls and the thickening rate of ventricular walls were measured in different stages after AMI. The hearts of the animals were harvested to measure the infarction area after executed respectively at 7th day and 1 month. Results The left ventricular volumes were enlarged and the thickness of ventricular wall in the infarction area were decreased in two groups after AMI, the difference with before AMI was statistically significant （ P 〈 0. 05, P 〈 0. 01 ）. The left ventricular volume and the thickness of ventricular wall were reversed at 1, 2, 3 hours after intravenous Lanatoside C in digitalis group, but there were no changes in the control group. However, the above different tendency between two groups were disappeared and the ventricular volume went enlargement when the infarction wall went thinning at the 7th day and 1 month. The thickening rate of infarction wall was remarkably decreased after AMI （P 〈 0.05 ） , while there was no significant changes in the border area and the non-infarction area. The infarction area was not significantly different between the two groups. Conclusion Digitalis may significantly improve the hemodynamic disorders, but don＇t show any impacts on the infarct size and the left ventricular remodeling in the microswine mode

关 键 词：洋地黄 急性心肌梗死 急性心力衰竭 左室重塑 

分 类 号：R541.6[医药卫生—心血管疾病]