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目的 探讨阿托伐他汀预处理对心肌缺血再灌注损伤大鼠的心肝肾保护作用及作用机制.方法 48只SD大鼠随机分为对照组、模型组、观察组,每组16只,对照组和模型组在造模前给予生理盐水灌胃每日1次10 ml/kg,连续4周.观察组在造模前给予阿托伐他汀混合液(浓度0.02 %)每日1次灌胃10 ml/kg,连续4周,建立心肌缺血再灌注模型.分别在缺血前、灌注 30 min后,检测天冬氨酸转移酶(aspartic acid transferase, GOT)、谷氨酸基转移酶(glutamate transferase ,GPT)、肌酐(creatinine,Cr)、尿素氮(urea nitrogen,BUN),超声仪记录左室收缩压(left ventricular systolic pressure,LVSP)、左室舒张压(left ventricular diastolic pressure,LVEDP)及左室收缩压的上升速度(maximal rate of the increase of left ventricular pressure,+dp/dtmax).伊文蓝染色、2,3,5-氯化三苯基四氮唑(2,3,5-triphenyltetrazolium chloride,TTC)检测心肌缺血及梗死面积,分别称左心室质量(左室相对重量)、右心室质量(右室相对重量)及室间隔厚度.结果 灌注后,模型组和观察组GOT、GPT、Cr、BUN均明显高于对照组,明显高于本组缺血前,差异有统计学意义(P<0.01).灌注后,观察组GOT、GPT、Cr、BUN明显低于模型组,差异有统计学意义(P<0.01).灌注后,模型组和观察组LVEDP明显高于对照组,明显高于本组缺血前,LVSP、+dp/dtmax明显低于对照组,明显低于本组缺血前,差异有统计学意义(P<0.01).灌注后,观察组LVSP、+dp/dtmax明显高于模型组,LVEDP明显低于模型组,差异有统计学意义(P<0.01).模型组和观察组心肌缺血率、心肌梗死率、心肌梗死/心肌缺血率明显高于对照组,差异有统计学意义(P<0.01).观察组心肌缺血率、心肌梗死率、心肌梗死/心肌缺血率明显低于模型组,差异有统计学意义(P<0.01).灌注后,模型组和观察组体重明显低于对照组,左室相对重量、右室相对重量、室间隔厚度明显高于对照组,差异有统计学意义(P<0.01).观察组体质量明显高于模型组,左室相对重量、右室相对重量、室间隔厚度明显低于模型组,差异有统计学意义(P<0.01).结论 阿托伐他汀预处理明显改善大鼠心肌缺血再灌注过程中血流动力学及肝肾功能,减少了心肌梗死面积,抑制心室重构.“,”Objective To explore the protective effect and mechanism of atorvastatin pretreatment on heart, liver and kidney in rats with myocardial ischemia reperfusion injury. Methods 48 SD rats were randomly divided into control group, model group and observation group, 16 in each group. The control group and model group were given physiologi?cal saline gavage once a day for 10ml/kg for 4 consecutive weeks before the mold-making. The observation group was given atorvastatin mixture(concentration 0.02%)once a day for 10ml/kg for 4 consecutive weeks, and the myocardial ischemia reperfusion model was established. Before and 30min after ischemia and perfusion, aspartate transferase (GOT), glutamate transferase(GPT), creatinine(Cr), and urea nitrogen(BUN)were detected. Evanblue staining, 2, 3, 3, 5-triphenyltetrazolium chloride(TTC)were used to detect myocardial ischemia and infarction area, which were respectively called left ventricular mass(left ventricular relative weight), right ventricular mass(right ventricular rela?tive weight)and ventricular septal thickness.Results After perfusion, GOT, GPT, Cr and BUN in the model group and the observation group were significantly higher than those in the control group, significantly higher than those before ischemia in this group, and the difference was statistically significant(P<0.01). After perfusion, GOT, GPT, Cr and BUN in the observation group were significantly lower than those in the model group, and the difference was statistical?ly significant(P<0.01). After perfusion, LVEDP in the model group and the observation group was significantly high?er than that in the control group, significantly higher than that before ischemia in this group. LVSP,+dp/dtmax was sig?nificantly lower than that in the control group, and significantly lower than that before ischemia in this group, and the difference was statistically significant(P<0.01). After perfusion, LVSP,+dp/dtmax in the observation group were sig?nificantly higher than that in the model group, and LVEDP was significantly lower than that in the model group, with statistically significant differences(P<0.01). The myocardial ischemia rate, myocardial infarction rate and myocardi?al infarction/myocardial ischemia rate in the model group and the observation group were significantly higher than those in the control group, and the difference was statistically significant(P<0.01). The myocardial ischemia rate, myocar?dial infarction rate and myocardial infarction/myocardial ischemia rate in the observation group were significantly lower than those in the model group, and the difference was statistically significant(P<0.01). After perfusion, the weight of the model group and the observation group was significantly lower than that of the control group, and the relative weight of the left ventricle, the relative weight of the right ventricle and the interventricular thickness were significantly higher than that of the control group, with statistically significant differences(P<0.01). The body weight of the observation group was significantly higher than that of the model group, and the relative weight of the left ventricle, the relative weight of the right ventricle and the thickness of the ventricular septum were significantly lower than that of the model group, with statistically significant differences(P<0.01).Conclusion The preconditioning of atorvastatin was signifi?cantly improved, and the hemodynamics and liver and kidney functions during myocardial ischemia reperfusion in rats reduced the area of myocardial infarction and inhibited ventricular remodeling.