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目的探讨糖皮质激素对心肌缺血-再灌注损伤的保护作用。方法将18只家兔应用冠状动脉左前降支结扎术造成心肌缺血模型,随机分成3组:心肌缺血再灌注损伤模型组(模型组)、糖皮质激素一次大剂量保护组(大剂量组)以及糖皮质激素多次小剂量保护组(小剂量组),每组6只。应用BL-420生物信号采集系统观察记录心电图ST段改变,分别在缺血前、缺血15 min以及再灌注30 min取血测定血浆丙二醛(MDA)浓度;缺血区心肌标本制作冰冻切片,行组织化学染色,观察缺血区琥珀酸脱氢酶活性变化。结果糖皮质激素的大、小剂量保护组再灌注过程中ST段恢复的时间较短,快于模型组;大剂量组血清MDA水平低于小剂量组(P<0.05),且两组均低于模型组(P<0.01);大剂量组缺血心肌琥珀酸脱氢酶活性高于小剂量组,且两组均明显高于模型组。结论糖皮质激素对心肌缺血-再灌注损伤可以起到有效的保护作用,一次大剂量的治疗保护效果要好于多次小剂量。
Objective To investigate the protective effect of glucocorticoids on myocardial ischemia-reperfusion injury. Methods Twenty-eight rabbits were randomly divided into 3 groups: model group with myocardial ischemia-reperfusion injury (model group), primary bolus group with glucocorticoid (high-dose group ) And glucocorticoid multiple low-dose protection group (small dose group), 6 in each group. The BL-420 biosignal acquisition system was used to observe and record ST segment changes of electrocardiogram. Plasma concentrations of MDA were measured before ischemia, 15 minutes after ischemia and 30 minutes after reperfusion. Frozen sections were prepared from ischemic myocardium Histochemical staining was performed to observe the change of succinate dehydrogenase activity in the ischemic area. Results The recovery time of ST segment during the reperfusion of glucocorticoid protective group was shorter than that of the model group. The serum MDA level of the high dose group was lower than that of the low dose group (P <0.05) (P <0.01). The activity of succinate dehydrogenase in ischemic myocardium in high-dose group was higher than that in low-dose group, and both groups were significantly higher than model group. Conclusion Glucocorticoids can protect myocardium from ischemia-reperfusion injury effectively. A large dose of therapeutic and protective effect is better than multiple small doses.