急性高血糖犬心表冠状动脉和心肌微血管储备功能的实验研究

The Experimental Study of Coronary Flow Reserve of Epicardial Coronary Artery And Myocardial Microvessels in Acute Hyperglycemic Dogs

目的 探讨急性高血糖对犬心表大冠状动脉和心肌微血管血流量和血流储备的影响。方法 静注双嘧达莫前后 ,应用血流仪和心肌对比超声心动图 (MCE)测量犬基础状态和高血糖状态时冠状动脉前降支和心肌微血管的血流量。结果 应用双嘧达莫前 ,基础状态和高血糖状态的前降支和心肌微血管的血流量 ( 13 .94± 2 .92比 15 .0 5± 8.61ml/min和 45 .49± 14 .2 8比 48.62± 2 9.5 9,P >0 .0 5 )以及微血管密度 ( 5 7.0 5± 7.87比 68.65± 10 .0 0 ,P >0 .0 5 )均无差异 ;应用双嘧达莫后 ,前降支血流量和血流储备无明显变化 ,而心肌微血管的血流量 ( 91.71± 42 .67比 41.16± 2 3 .15 ,P <0 .0 1)、血流储备 ( 2 .15± 1.3 0比 0 .84± 0 .44 ,P <0 .0 5 )和血管密度 ( 86.78± 2 1.84比65 .18± 2 8.5 8,P <0 .0 5 )明显下降。结论 急性高血糖减少双嘧达莫负荷后的心肌微血管的血流量。

Objective To investigate the influence of acute hyperglycemia on coronary blood flow(CBF) and coronary flow reserve(CFR) of left anterior descending coronary artery(LAD) and myocardial microvessles.Methods The CBF of LAD and myocardial microvessles were measured with flowmeter and myocardial contrast echocardiography(MCE) before and after dipyridamole intravenous administration in basal and hyperglycemia state.Results Before intravenous administration of dipyridamole,the CBF of LAD and myocardial microvessles(13.94±2.92 vs 15.05±8.61ml/min and 45.49±14.28 vs 48.62±29.59,P>0.05) and density of myocardial microvessles(57.05±7.87 vs 68.65±10.00,P>0.05) were comparable.After dipyridamole administration,CBF and CFR of LAD had no change,but CBF,CFR and density of myocardial microvessles(91.71±42.67 vs 41.16±23.15,P<0.01,2.15±1.30 vs 0.84±0.44,P<0.05 and 86.78±21.84 vs 65.18±28.58,P<0.05 respectively) reduced obviously.Conclusion Acute hyperglycemia impairs CBF,CFR and reduces density of myocardial microvessles . [