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目的:探讨体外反搏改善心肌缺血犬血流动力学的作用和内皮素机制。方法:19只健康杂种犬随机分为对照组、缺血组和反搏组,分别于冠状动脉左前降支结扎前和结扎后60MIN、120 MIN、180 MIN记录以下指标: ①主动脉根部血压;②左心室收缩和舒张末压、+DP/DTMAX和-DP/DTMAX;③头臂干血流量;④放免法检测血浆和心肌内皮素-1(ET-1)的含量。结果:冠脉结扎1 H,缺血组和反搏组犬血压、左心室收缩和舒张功能、头臂干血流量明显低于正常组(P<0．05),而血浆ET-1水平明显高于正常组(P<0．05)。经过体外反搏2 H,反搏组犬的收缩压、舒张压和平均压、左心室收缩和舒张功能、头臂干血流量明显高于缺血组(P<0．05);而反搏组犬的血浆和心肌ET-1 水平明显低于缺血组(P<0．05)。结论:体外反搏可改善心肌缺血犬血流动力学指标,其机制可能与降低ET-1的产生有关。
Objective: To explore the effect of extrinsic counterpulsation on hemodynamics and the mechanism of endothelin in myocardial ischemic dogs. Methods: Nineteen healthy mongrel dogs were randomly divided into control group, ischemic group and counterpulsation group. The following indexes were recorded at 60 MIN, 120 MIN and 180 MIN respectively before left anterior descending coronary artery ligation and ligation: ① aortic root pressure; (2) left ventricular systolic and diastolic pressure, + DP / DTMAX and -DP / DTMAX; (3) dry arm blood flow; (4) radioimmunoassay to detect plasma and cardiac endothelin-1 content. Results: Canine blood pressure, left ventricular systolic and diastolic function, blood flow in the brachiocephalic trunk were significantly lower than those in the normal group (P <0.05), while plasma ET-1 levels were significantly higher Higher than the normal group (P <0.05). After extrinsic counterpulsation2H, systolic blood pressure, diastolic blood pressure and mean pressure, left ventricular systolic and diastolic function, and brachiocephalic stem blood flow were significantly higher in the EECP group than those in the ischemic group (P <0.05) ET-1 levels in plasma and myocardium of the dogs were significantly lower than those of the ischemic group (P <0.05). Conclusion: EECP can improve the hemodynamics of myocardial ischemia in dogs, which may be related to the decrease of ET-1 production.