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目的:观察极化液(葡萄糖-胰岛素-钾液,G IK)对急性心肌缺血/再灌注(M I/R)犬心脏功能、冠脉血流量及心肌损伤的影响,分析胰岛素在G IK上述效应中的作用。方法:制备犬M I/R模型,心肌定量缺血(左前降支血流量降低80%)50 m in,再灌注4 h。24只杂种犬随机分为G IK、葡萄糖-钾液(GK)和盐水对照组(n=8/组),再灌注前5m in输注G IK、GK、生理盐水。观察冠脉血流量及血流动力学指标;检测不同时间血清乳酸脱氢酶(LDH)、肌酸激酶(CK)活性;再灌注4 h后测量并计算心肌梗死范围。结果:与盐水对照组相比,G IK明显增加左前降支冠脉血流量(CBFLAD),改善再灌注后左室收缩及舒张功能,降低血清CK、LDH,减少心肌梗死范围,而GK无上述作用。结论:再灌注时输注G IK可促进再灌注心脏功能恢复及减轻心肌损伤,该作用可能与G IK增加冠脉血流量有关;胰岛素是G IK上述作用的关键成分。
OBJECTIVE: To observe the effect of polarized fluid (glucose-insulin-potassium solution, G IK) on cardiac function, coronary blood flow and myocardial injury in acute myocardial ischemia / reperfusion (MI / R) Effect of the role. Methods: The canine M I / R model was established. Myocardial ischemia (left anterior descending branch blood flow reduced by 80%) for 50 min and reperfusion for 4 h. Twenty-four hybrids were randomly divided into G IK, GK and saline control groups (n = 8 / group). G IK, GK and normal saline were infused 5 min before reperfusion. Coronary blood flow and hemodynamic parameters were observed. Serum lactate dehydrogenase (LDH) and creatine kinase (CK) activity were measured at different time points. The extent of myocardial infarction was measured 4 hours after reperfusion. Results: Compared with saline control group, G IK significantly increased CBFLAD, improved left ventricular systolic and diastolic function after reperfusion, decreased serum CK and LDH, and decreased myocardial infarct size. However, effect. CONCLUSION: Infusion of G IK at reperfusion can promote cardiac function recovery and relieve myocardial injury after reperfusion, which may be related to the increase of coronary blood flow with G IK. Insulin is a key component of G IK.