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目的评价福辛普利防治猪急性心肌梗死再灌注后无再流的作用。方法中华小型猪24只随机分成对照组、福辛普利组(1mg·kg-1·d-1)和假手术组,每组8只。冠状动脉结扎3h,松解1h制备急性心肌梗死再灌注模型。梗死前、后和再灌注后均行血液动力学测定和心肌声学造影检查,最终行病理学分析。结果心肌声学造影和病理染色所测的冠状动脉结扎区心肌范围(LA)差异无统计学意义。与对照组相比,福辛普利可促进急性心肌梗死后心功能的恢复,增加再灌注后1h冠状动脉血流量(对照组50·6%,福辛普利组72·1%,P<0·01),减少无再流面积(对照组心肌声学造影和病理:78·5%和82·3%LA;福辛普利组心肌声学造影和病理:24·5%和25·2%LA,P均<0·01),减少心肌坏死面积(对照组98·5%,福辛普利组88·9%LA,P<0·05)。结论福辛普利能有效地防治心肌梗死再灌注后无再流。
Objective To evaluate the effect of fosinopril on preventing no-reflow after reperfusion of acute myocardial infarction in pigs. Methods 24 Chinese miniature pigs were randomly divided into control group, fosinopril group (1mg · kg-1 · d-1) and sham-operation group, 8 rats in each group. Coronary ligation 3h, release 1h acute myocardial infarction reperfusion model. Hemodynamic and myocardial contrast echocardiography were performed before and after infarction and after reperfusion, and finally pathological analysis was performed. Results There was no significant difference in myocardial area (LA) measured by myocardial contrast echocardiography and pathological staining in the coronary artery ligation area. Compared with the control group, fosinopril could promote the recovery of cardiac function after acute myocardial infarction and increase the coronary blood flow 1h after reperfusion (50.6% in the control group and 72.1% in the fosinopril group, P < 0.01), reduced no-reflow area (control group, myocardial contrast echocardiography and pathology: 78.5% and 82.3% LA, and Fosinopril group, myocardial contrast echocardiography and pathology: 24.5% and 25.2% LA and P <0.01, respectively. The area of myocardial necrosis was decreased (98.5% in the control group and 88.9% LA in the fosinopril group, P <0.05). Conclusion Fosinopril can effectively prevent and treat myocardial infarction without reperfusion after reperfusion.