论文部分内容阅读
目的 :本文应用冠脉血流显像技术评价缺血再灌注对冠脉反应性充血的影响 ,并分析缺血预适应对再灌注后冠脉反应性充血的改善作用。方法 :将 17条杂种犬分为两组 :缺血再灌注组 (IR组 ,n=9)、持续缺血再灌注前先行反复三次短暂性缺血预处理组 (IP+IR组 ,n=8)。测量基础状态和最大充血状态下峰值速度、速度时间积分 ,并计算充血时最大峰值血流速度与基础速度比值、速度时间积分比值 (即 PRV:BV和 VTIPR:VTIBASE)。计算左室射血分数 (L VEF)以及再灌注后 L VEF恢复值 (再灌注 1小时值 -缺血 1小时值 )。测量冠状静脉血浆中内皮素含量。处死犬后 ,将心肌用 Evan s蓝和 TTC染色 ,测量坏死区和危险区心肌面积 ,计算二者之比 (NA:RA)。从危险区中采集心肌标本放置于固定液中 ,进行电镜检查。结果 :各组缺血和再灌注 1小时时左室射血分数较同组基础状态有明显下降 ,差异有显著性意义 (P均 <0 .0 5 ) ;再灌注后 ,各组射血分数均较缺血 1小时时有所改善 ,差异有显著性意义 (P均 <0 .0 5 )。虽然再灌注 1小时时各组间射血分数无显著性差异 (P>0 .0 5 ) ,但 IP+IR组的射血分数恢复值高于 IR组 ,差异均有显著性意义 (P均 <0 .0 5 )。 IP+IR组 NA:RA值均较 IR组降低 ,差异有显著性意义。IR组再灌注 1小时反映反应性充?
Objective: To evaluate the effect of ischemia-reperfusion on coronary reactive hyperemia by coronary flow imaging and to evaluate the effect of ischemic preconditioning on coronary reactive hyperemia after reperfusion. Methods: Seventeen hybrid dogs were divided into two groups: ischemia-reperfusion group (IR group, n = 9), three times of transient ischemic preconditioning (IP + IR group, n = 8). The peak velocity and velocity time integral under the maximal congestive state were measured and the ratio of the maximum peak blood flow velocity to the base velocity and the velocity time integral (ie, PRV: BV and VTIPR: VTIBASE) during congestion were calculated. Left ventricular ejection fraction (L VEF) and L VEF recovery after reperfusion (1 hour reperfusion - 1 hour ischemia) were calculated. Endothelin levels in coronary venous plasma were measured. After the dogs were sacrificed, the myocardium was stained with Evan’s blue and TTC, and the myocardial area in the necrotic area and the risk area was measured. The ratio (NA: RA) was calculated. Myocardial specimens collected from the danger zone were placed in a fixative and subjected to electron microscopy. Results: The left ventricular ejection fraction at 1 hour after ischemia and reperfusion in each group was significantly lower than that in the same group (all P <0.05). After reperfusion, the ejection fraction Compared with ischemia 1 hour, the difference was significant (P <0.05). Although there was no significant difference (P> 0.05) in ejection fraction at 1 hour after reperfusion, the ejection fraction of IP + IR group was higher than that of IR group (P <0.05) <0 .0 5). The NA: RA values of IP + IR group were lower than those of IR group, the difference was significant. IR group reperfusion 1 hour to reflect the reaction charge?