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目的 :探讨胺碘酮、美托洛尔对兔急性心肌梗死 (AMI)血小板活化、纤溶活性、内皮血管活性物质的影响。方法 :新西兰家兔 5 0只 ,随机分为 5组 ,每组 10只。Ⅰ组 :假手术组 ,Ⅱ组 :AMI组 ,Ⅲ组 :AMI+利多卡因组 ,Ⅳ组 :AMI+胺碘酮组 ,Ⅴ组 :AMI+美托洛尔组 ;Ⅱ、Ⅲ、Ⅳ、Ⅴ组分别结扎冠状动脉左室支中点后 ,4h取血分别测定血栓素B2 (TXB2 )、6 -酮 -前列腺素F1α( 6 -Keto-PGF1α)、内皮素 (ET)、一氧化氮 (NO)和组织型纤溶酶原激活剂 (t-PA)、纤溶酶原激活剂抑制物 (PAI)水平 ;摘取心脏 ,测定心肌梗死范围。结果 :Ⅱ、Ⅲ、Ⅳ、Ⅴ组血浆TXB2 、ET、NO浓度和PAI活性显著高于Ⅰ组 (P <0 0 1) ,6 -Keto-PGF1α浓度和t-PA活性显著低于Ⅰ组 (P <0 0 1) ,Ⅱ、Ⅲ、Ⅳ组之间比较 ,血浆TXB2 、6 -Keto-PGF1α浓度、t-PA活性及心肌梗塞范围无显著差异 (P >0 0 5 ) ,Ⅳ组血浆ET、NO浓度和PAI水平明显低于Ⅱ组 (P <0 0 1) ,Ⅴ组血浆TXB2 、ET、NO浓度和PAI水平明显低于Ⅱ组 (P <0 0 1) ,6 -Keto -PGF1α浓度、t-PA活性显著高于Ⅱ组 (P <0 0 1) ,心肌梗塞范围小于Ⅱ组 (P <0 0 1)。结论 :胺碘酮抑制AMI早期PAI活性 ,减少ET和NO的释放 ;美托洛尔抑制AMI早期血小板活化 ,改善纤溶活性 ,减少ET和NO的再释放 ,缩小?
Objective: To investigate the effects of amiodarone and metoprolol on platelet activation, fibrinolytic activity and endothelium vasoactive substances in rabbits with acute myocardial infarction (AMI). Methods: Fifty New Zealand rabbits were randomly divided into 5 groups with 10 in each. Group Ⅰ: sham operation group, group Ⅱ: AMI group, group Ⅲ: AMI + lidocaine group, group Ⅳ: AMI + amiodarone group, groupⅤ: AMI + metoprolol group; groupⅡ, Ⅲ, After ligation of the midpoint of left ventricular branches of coronary artery, blood was collected at 4h to determine the levels of TXB2, 6-keto-PGF1α, ET, NO and Tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI) levels; heart removal, determination of myocardial infarction range. Results: The levels of plasma TXB2, ET, NO and PAI in group Ⅱ, Ⅲ, Ⅳ and Ⅴ were significantly higher than those in group Ⅰ (P <0.01), and the concentrations of 6-Keto-PGF1α and t-PA were significantly lower than those in group Ⅰ P <0.01). There was no significant difference in plasma TXB2, 6-Keto-PGF1α, t-PA activity and infarct size between groups Ⅱ, Ⅲ and Ⅳ (P> 0.05) (P <0.01). The levels of plasma TXB2, ET, NO and PAI in group V were significantly lower than those in group Ⅱ (P <0.01). The concentration of 6-Keto-PGF1α , The activity of t-PA was significantly higher than that of group Ⅱ (P <0.01), the range of myocardial infarction was smaller than that of group Ⅱ (P <0.01). Conclusions: Amiodarone can inhibit the early PAI activity of AMI and decrease the release of ET and NO. Metoprolol inhibits the early platelet activation of AMI, improves the fibrinolytic activity and reduces the release of ET and NO,