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目的探讨肾素－血管紧张素系统（ＲＡＳ）在围手术期心肌缺血中的作用。方法杂种犬４０只均分为４组：Ⅰ组：对照组；Ⅱ组：心肌梗塞模型组；Ⅲ组：心梗＋胃大部切除组；Ⅳ组：心梗＋卡托普利＋胃大部切除组。取不同部位心脏测肾素和ＡｎｇⅡ，测Ⅲ、Ⅳ组基础、术前和术后的血流动力学和生化指标。结果在Ⅲ组，手术引起左室压最大上升速率及心脏指数下降，致左室舒张末期压、肺动脉嵌压、左室舒张压力下降时间常数（Ｔ值）、总外周阻力（ＴＰＲ）及内皮素、肾素、α－颗粒膜蛋白和ＡｎｇⅡ升高；在Ⅳ组，用药后４０ｍｉｎ，ＴＰＲ和ＡｎｇⅡ下降，Ｔ值和肾素升高；手术使血流动力学回降，其余指标不变。对局部ＲＡＳ、心梗后肾素、ＡｎｇⅡ均增多，手术使ＡｎｇⅡ更多，卡托普利能防止其发生。结论心梗后行胃大部切除术能致左心舒缩功能障碍及激活ＲＡＳ；卡托普利能预防其发生。
Objective To investigate the role of renin-angiotensin system (RAS) in perioperative myocardial ischemia. Methods 40 dogs were divided into 4 groups: group Ⅰ: control group; group Ⅱ: myocardial infarction model group; group Ⅲ: myocardial infarction + gastrectomy group; group Ⅳ: myocardial infarction + captopril + Department of resection group. Take the heart of different parts of the test of renin and Ang Ⅱ, Ⅲ, Ⅳ group based on preoperative and postoperative hemodynamic and biochemical indicators. Results In group Ⅲ, the maximal rate of increase of left ventricular pressure and the decrease of cardiac index were induced by surgery. The changes of left ventricular end - diastolic pressure, pulmonary arterial pressure, left ventricular diastolic pressure drop time constant (T value), total peripheral resistance (TPR) and endothelin , Renin, α-granule membrane protein and Ang Ⅱ increased; in group Ⅳ, 40 min after treatment, TPR and Ang Ⅱ decreased, T value and renin increased; hemodynamics fell back by surgery, the remaining indicators unchanged. Right local RAS, renin after myocardial infarction, Ang Ⅱ are increased, more Ang Ang surgery, captopril to prevent its occurrence. Conclusions Subtotal gastrectomy can cause left ventricular systolic dysfunction and activate RAS. Captopril can prevent its occurrence.