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目的:评价地尔硫(艹卓)的药物后处理,与缺血后处理相比,对于抑制心肌缺血—再灌注损伤及保护心肌组织的作用及相关机制。方法:72只实验大鼠随机分为6组,每组12只,包括假手术组、对照组、缺血后处理组、地尔硫(艹卓)1组(D1组)、地尔硫(艹卓)2组(D2组)、地尔硫(艹卓)3组(D3组)。假手术组:心脏只穿针不结扎;对照组:再灌注前由右颈动脉插管至主动脉窦部,注射0.9%生理盐水0.4 ml,再灌注3 h;缺血后处理组:心肌缺血45 min后给予4轮30 s缺血、30 s再灌注处理;地尔硫(艹卓)1组(D1组):再灌注前30 s注射50%地尔硫(艹卓)注射液700μg/kg,2 min内注射完毕;地尔硫(艹卓)2组(D2组):首次注射同D1组,之后以5μg/(kg·min)的速度维持推注2 h;地尔硫(艹卓)3组(D3组):首次注射后以10μg/(kg·min)的速度维持2 h。结果:与对照组相比,再灌注3 h后地尔硫(艹卓)各组心肌坏死面积显著减少、血清肌酸激酶MB同工酶(CK-MB)水平较低、组织一氧化氮(NO)、丙二醛(MDA)水平较低,超氧化物歧化酶(SOD)水平较高,作用强度与缺血后处理组相近,D2组、D3组的左心室内压最大收缩和舒张变化速率(±dp/dt_(max))均有显著提高。结论:在急性心肌缺血充分再灌注前,应用地尔硫(艹卓)行药物后处理,可减少心肌梗死面积、改善心功能、减低心肌组织内自由基水平,作用效果与灌注时限、剂量有一定关系。
OBJECTIVE: To evaluate the pharmacological effects of diltiazem on post-treatment of myocardial ischemia-reperfusion injury and its protective effect on myocardium compared with ischemic postconditioning. Methods: Seventy two experimental rats were randomly divided into six groups (n = 12 each), including sham operation group, control group, ischemic postconditioning group, diltiazem group 1 (D1 group), diltiazem艹 Zhuo) 2 group (D2 group), diltiazem (艹 Zhuo) 3 group (D3 group). Sham operation group: the heart only needles were not ligated; control group: before reperfusion, the right carotid artery was cannulated into the aortic sinus, 0.9 ml normal saline 0.4 ml and reperfusion 3 h; ischemic postconditioning group: After 45 min of ischemia, rats were sacrificed for 4 rounds of 30 seconds of ischemia and 30 seconds of reperfusion. Diltiazem Group 1 (D1): 50% Diltiazem injection / kg in 2 min; Diltiazem group 2 (D2 group): the first injection with the D1 group, followed by injection of 5μg / (kg · min) for 2 h; diltiazem艹 Zhuo) 3 groups (D3): After the first injection at 10μg / (kg · min) speed of 2 h. Results: Compared with the control group, the area of myocardial necrosis, the serum creatine kinase MB isoenzyme (CK-MB) and the nitric oxide NO), lower malondialdehyde (MDA) and higher level of superoxide dismutase (SOD). The intensity of action was similar to that of ischemic postconditioning group. The maximum systolic and diastolic changes of left ventricular pressure Speed (± dp / dt_ (max)) were significantly improved. Conclusion: Diltiazem pretreatment before acute myocardial ischemia reperfusion can reduce the area of myocardial infarction, improve cardiac function, reduce the level of free radicals in myocardium, the effect and duration of perfusion, dosage Have a certain relationship.