心力衰竭犬血小板功能及血浆血管性血友病因子、内皮素1改变的实验研究  

Experimental Investigation of Platelet and Endothelial Function in Pacing-Induced Canine Heart Failure Model

作　　者：薛竟宜[1] 杨树森[1] 李悦[1] 李为民[1] 李杰[1] 徐岩松[1] 沈景霞[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心内科,黑龙江省哈尔滨市150001

出　　处：《中国循环杂志》2004年第2期100-103,共4页Chinese Circulation Journal

摘　　要：目的 :观察慢性心力衰竭犬血小板聚集功能和血浆血管性血友病因子 (vWF)、内皮素 1(ET 1)和血管紧张素Ⅱ (AngⅡ )含量的变化 ,探讨心力衰竭血栓前状态的形成机制。方法 :14只犬随机分为起搏组 (8只 )和假手术组 (6只 ) ,起搏组犬植入实验用心室非同步固定频率起搏方式 (VOO)型起搏器 ,行心室快速起搏 (2 2 0次 /分 ) 6周 ,建立心力衰竭犬模型。起搏组犬于起搏前和起搏后 6周 ,假手术组犬于术前和术后 7周采静脉血测定血小板最大聚集率及血浆vWF、ET 1和AngⅡ含量。结果 :①假手术组犬术前与术后 7周比较 ,心脏功能、血小板最大聚集率及血浆vWF、ET 1、AngⅡ含量均无明显变化。②快速心室起搏后 6周 ,起搏组所有犬出现心功能不全症状 ,心脏每搏量、心输出量、左心室射血分数及心脏指数较起搏前明显降低 ,有显著性差异 (P <0 0 5～ 0 0 1) ;③起搏组犬快速心室起搏后 6周 ,由二磷酸腺苷、肾上腺素、胶原和花生四烯酸诱导的血小板最大聚集率较起搏前增加 ,有极显著性差异 (P <0 0 1) ;④快速心室起搏后 6周 ,起搏组犬血浆vWF、ET 1及AngⅡ含量较起搏前升高 ,有极显著性差异 (P <0 0 1)。结论 :血小板聚集功能增强、血浆vWF和ET 1含量升高 ,是导致心力衰竭血栓前状态形成的重要因素之一。Objective: To investigate the changes of platelet function,and to elucidate the mechanism of prothrombotic state in congestive heart failure canines induced by chronic rapid ventricule pacing. Methods: Right ventricule pacing was made at 220 bpm in for 6 weeks in 8 caninds. The platelet aggregation rate and plasma von Willebrand factor,endothelin-1 angiotension Ⅱlevels were determined before and after ventricule pacing. Cardiac function were examined by esophagoultrasound before and after pacing. Results:After rapid ventricule pacing for 6 weeks,stroke volume,cardiac output,ejection fraction and cardiac index were decreased significantly in 8 canines( p <0.05—0.01).Maximum platelet aggregation rates induced by four different agonists (adenosine diphosphate,epinephrine,collagen,arachidonic acid) were increased significantly after rapid ventricule pacing for 6 weeks( p <0.01).Plasma von Willebrand factor,endothelin-1,angiotension Ⅱlevels were consistently increased after chronic rapid ventricule pacing( p <0.01). Conclusion: Endothelial dysfunction and enhanced platelet aggregation function may play an important role in the development of prothrombotic state in congestive heart failure.

关 键 词：心力衰竭 血小板功能 血浆血管性血友病因子 内皮素-1 实验研究 

分 类 号：R541.6[医药卫生—心血管疾病]