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目的扩大缺血后处理在临床上的应用,验证“渐处理”,即一种改良的后处理方式是否对再灌注心肌有保护作用。方法建立犬心肌缺血/再灌注(I/R)模型,缺血40min后分别给予以下处理:(1)再灌注3h;(2)后处理,缺血30s,再灌注30s,进行3个循环后放开冠状动脉进行再灌注3h;(3)渐处理,逐步恢复冠状动脉血流,50%2min,80%2min,之后再灌注3h。全程监测心电图和心功能指标,检测血清中心肌酶活性,再灌注结束后对心脏进行伊文思蓝-红四氮唑(TTC)染色判断心肌坏死率。结果上述各项指标显示后处理和渐处理均降低了I/R损伤,减少了再灌注诱发的心律失常。结论作为一种改良的后处理方式,渐处理对再灌注心肌的保护作用显著。
Objective To expand the clinical application of ischemic postconditioning to verify “progressive treatment”, that is, whether an improved post-treatment method has a protective effect on reperfusion myocardium. Methods The canine model of myocardial ischemia / reperfusion (I / R) was established. After ischemia for 40 min, the following treatments were given respectively: (1) reperfusion for 3 h; (2) postconditioning, ischemia for 30 s and reperfusion for 30 s, Then release the coronary artery for reperfusion 3h; (3) gradually treated, and gradually restore coronary blood flow, 50% 2min, 80% 2min, followed by reperfusion 3h. The electrocardiogram and cardiac function indicators were monitored during the whole process. Serum myocardial enzyme activities were measured. Myocardial necrosis was assessed by Evans blue-red tetrazolium (TTC) staining after reperfusion. Results The above indexes showed that both post-treatment and gradual treatment reduced I / R injury and reduced reperfusion-induced arrhythmia. Conclusion As a modified post-treatment method, the protective effect of progressive treatment on myocardial reperfusion injury is significant.