左心辅助装置对缺血性心衰犬血浆脑钠素水平的影响  

Effects of the left ventricular assist device on BNP

作　　者：陆军[1] 肖学钧[1] 董辉[1] 成安衡[1] 黄焕雷[1] 

机构地区：[1]广东省心血管病研究所心外科,广州市510080

出　　处：《岭南心血管病杂志》2003年第1期44-47,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的　研究急性缺血性左心功能不全时左心辅助装置 (LVAD)对左心功能的影响和血浆脑钠素 (BNP)变化情况。方法　将 10只健康成年犬随机分为对照组 (A)和辅助组 (B) ,两组皆以主动脉 -左心房旁路方式植入左心辅助装置 ,在阻断实验犬左冠脉前降支主干 4 0min后开放血流 ,其中仅对B组实验犬进行左心辅助。监测 6h内两组实验犬平均动脉压 (MAP)、心输出量 (CO)、左室收缩末期压(LVESP)、肺毛细血管楔压 (PCWP)、左室压力一阶导数(LVdp/dt)等血流动力学指标及血浆BNP水平变化情况。结果　开放左前降支 6h后 ,对照组实验犬 :MAP(72 2± 8 11)mmHg,LVESP (88 8± 5 4 )mmHg ,LVdp/dt 1839± 176 ,PCWP(9 6 8± 1 4 1)mmHg ,CO(0 98± 0 13)L/min ,BNP(15 3± 7 13)pg/mL。经过 6h左心辅助循环 ,辅助组实验犬各项血流动力学指标明显改善 ,MAP (87± 6 0 4 )mmHg ,LVESP(12 1 6± 2 88)mmHg ,LVdp/dt 2 5 90± 12 6 ,PCWP (6 5 6±0 5 1)mmHg ,CO(1 5 2± 0 16 )L/min ,BNP(6 2 5± 3 4 7)pg/mL基本降至正常水平。血浆BNP水平基本不受血流动力学变化影响。结论　左心辅助装置对于缺血性心衰具有良好的治疗作用 ,促进了心肌功能恢复 ,明显降低血浆BNP水平 ,血浆BNP水平可以较好地反映心肌功能状态。Objectives This study was undertaken to explore the effects of left ventricular assist device (LVAD) on failing dog heart after myocardial ischemia and to observe the change of level of plasma brain natriuretic peptide (BNP) during 6 hours after LVAD implantation.Methods 10 adult healthy dogs were divided into 2 groups randomized. The Luo-Ye pump was implanted in LA-AO bypass in 2 groups. Myocardial ischemia was induced by ligating the main left anterior descending coronary artery (LAD). In group A, it was untied after a ligation of 40 minutes and the myocardium was reperfused for 6 hours. In group B, after a ligation of 40 minutes, the LAD was untied and the LVAD was used for LV support for 6 hours.Results After 6 hours reperfusion,group A:MAP(72.2±8.11)mmHg, LVESP(88.8±5.4)mmHg, LVdp/dt 1 839±176, PCWP(9.68±1.41)mmHg, CO(0.98±0.13)L/min,BNP(153±7.13)pg/mL, group B: MAP(87±6.04)mmHg, LVESP(121.6±2.88)mmHg, LVdp/dt 2 590±126, PCWP(6.56±0.51)mmHg, CO(1.52±0.16)L/min,BNP(62.5±3.47)pg/mL. There was a weak relationship between circulating BNP and hemodynamics.Conclusions LVAD was beneficial to the recovery of cardiac function and can reduce the plasma levels of BNP. Plasma BNP level may be a predictive factor of recovery.

关 键 词：左心辅助装置 缺血性心衰 脑钠素 血流动力学 左心功能不全 

分 类 号：R541.6[医药卫生—心血管疾病]