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目的探索帕瑞昔布联合右颈交感神经干离断(TCST)对大鼠心肌梗死后左室重构的影响。方法成年雄性SD大鼠40只,采用结扎左冠状动脉前降支方法制备急性心肌梗死模型,制模成功后,采用右TCST治疗和(或)给予帕瑞昔布8 mg·kg~(-1)·d~(-1)治疗。于建模处置4wk后行右颈总动脉插管测定左心室收缩压(LVSP)、左心室舒张末期压(LVEDP)、左心室收缩压上升最大速率(+dp/dt_(max))和左心室收缩压下降最大速率(-dp/dt_(max));放射免疫法检测血浆血栓素A_2(TXA_2)和前列腺素I_2(PGI_2)的浓度;体视学三维形态定量分析左室重构,测定左室心肌细胞体积密度Vv、心肌组织总体积Vt、心肌细胞总体积Vc。结果心肌梗死制模后各组LVSP、±dp/dt_(max)明显降低,而LVEDP升高(均P<0.01),PGI_2、PGI_2/TXA_2显著降低、TXA_2增加(P<0.01),Vv、Vt、Vc均明显升高(P<0.01);右TCST或帕瑞昔布治疗后LVSP及±dp/dt_(max)升高(P<0.01或P<0.05)而LVEDP降低,PGI_2、PGI_2/TXA_2显著增加而TXA_2降低,Vv、Vt、Vc均降低(P<0.01);右TCST联用帕瑞昔布后心功能改善更显著,Vv、Vt、Vc降低更明显(P<0.05)。结论帕瑞昔布与右TCST单用及合用均能显著提高心肌舒缩功能,调节PGI_2与TXA_2的相对平衡,延缓急性心肌梗死大鼠的左室重构过程,但两者合用效果更佳。
Objective To explore the effect of parecoxib combined with right cervical sympathetic trunk disruption (TCST) on left ventricular remodeling after myocardial infarction in rats. Methods Forty adult male Sprague-Dawley rats were used to establish the model of acute myocardial infarction by ligation of left anterior descending coronary artery. After successful modeling, the right TCST and / or parecoxib 8 mg · kg -1 ) · D ~ (-1) treatment. Left ventricular systolic pressure (LVSP), left ventricular end-diastolic pressure (LVEDP), maximum rate of left ventricular systolic pressure increase (+ dp / dt max) and left ventricular The maximum systolic blood pressure (-dp / dt_ (max)) was measured by radioimmunoassay. Thromboxane A_2 (TXA_2) and prostaglandin I_2 (PGI_2) concentrations were measured by radioimmunoassay. Left ventricular remodeling was quantitatively analyzed by three- Ventricular cardiomyocyte volume density Vv, total myocardial tissue volume Vt, total myocardial cell volume Vc. Results LVSP, ± dp / dt max, LVEDP, PGI 2, PGI 2 / TXA 2, TXA 2, Vv and Vt in myocardial infarction group were significantly lower than those in control group (P <0.01) (P <0.01 or P <0.05), LVEDP decreased, PGI_2 and PGI_2 / TXA_2 increased significantly (P <0.01), while LVSP and ± dp / dt max increased (P <0.01). The improvement of cardiac function in the right TCST combined with parecoxib was more significant and the decrease of Vv, Vt and Vc was more obvious (P <0.05). Conclusion Both parecoxib and right TCST can significantly improve myocardial contractile and diastolic function, regulate the relative balance of PGI_2 and TXA_2, delay the process of left ventricular remodeling in acute myocardial infarction rats, but the combined effect is better.