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目的 为研究和治疗局部心肌顿抑制备在体动物模型。方法 杂种犬 36条 ,冠状动脉左前降支阻断15 min后 ,再灌注 30 min。分别于冠脉阻断前、冠脉阻断 5、10、15 min及再灌注 5、10、2 0、30、6 0 m in测定血流动力学指标 ,并于再灌注后 30 min取左、右心室标本送电子显微镜检查。结果 心率在缺血 /再灌注过程中均明显增快 ;平均动脉压在冠脉阻断期间稍下降 (P <0 .0 5 ) ,再灌注后升至基础水平 ;冠脉阻断后心排血量、每搏量、左室收缩功指数均迅疾下降 ,再灌注 5 min略有上升 ,之后又呈进行性下降 ;冠脉阻断后心律失常发生率为 5 6 .7% ,再灌注心律失常发生率 40 % ,其中 3例冠脉开放突发室颤死亡。心肌超微结构 :再灌注 30 min:心肌纤维肿胀 ,间质明显水肿 ,毛细血管淤血 ,线粒体大量空泡。结论 犬 L AD阻断 15 min,再灌注后出现明显的心肌顿抑 ;缺血 /再灌注心律失常发病率高 ,治疗困难
Objective To study and treat local myocardial stunning in animals prepared in vivo model. Methods 36 hybrid dogs, left anterior descending coronary artery occlusion 15 min, reperfusion 30 min. The hemodynamic parameters were measured before coronary occlusion, at 5, 10, 15 min after coronary occlusion and at 5, 10, 20, 30, and 60 min after reperfusion, respectively. , Right ventricular specimens sent electron microscopy. Results The heart rate was significantly increased during ischemia / reperfusion. Mean arterial pressure slightly decreased during the period of coronary artery occlusion (P <0.05), and then rose to basal level after reperfusion. Blood volume, stroke volume, left ventricular systolic function index decreased rapidly, 5 min after reperfusion increased slightly, followed by progressive decline; the incidence of arrhythmia after coronary occlusion was 56.7%, reperfusion heart rate The incidence of malaria 40%, of which 3 cases of sudden coronary open-ventricular fibrillation died. Myocardial ultrastructure: reperfusion 30 min: myocardial fibrosis, interstitial edema, capillary congestion, a large number of vacuoles mitochondria. Conclusions Canine L AD blockade for 15 min, obvious myocardial stunning after reperfusion; high incidence of ischemia / reperfusion arrhythmia, difficult treatment