等容血液稀释和葡萄糖-胰岛素-氯化钾溶液对狗急性心肌梗塞早期左心室功能的改善

Improvement of left ventricular function with isovolumetric hemodilution and glucose-insul ine-potassium in the early phase of acute myocardial infarction in dogs

在麻醉开胸纯氧呼吸狗急性心肌梗塞(AMI)模型上,观察了右旋糖酐40等容稀释血液和静滴葡萄糖-胰岛素-氯化钾溶液(GIK)对狗AMI 6h内左心功能(±dP/dt-max,LVSP)的改善作用。结果:单用等容血液稀释或静滴GIK溶液仅使+dP/dt-max较对照组(未给治疗)明显升高(P<0.05),但前者发挥作用较快;二者联合应用不仅能使+dP/dt-max、LVSP较对照组均明显升高(P<0.05),而且可使-dp/dt-max、LVSP较单用等客血液稀释或静滴GIK溶液组明显升高(P<0.05)。提示:①等容血液稀释或静滴GIK溶液对AMI早期左心室收缩功能均有显著改善作用;②前者发挥作用较快;③二者联合应用不仅能进一步改善AMI后左心室收缩功能,且对舒张功能也有显著改善作用,表现出良好的协同效应。

The effects of isovolumetric hemodilution with dextran 40 or glucose-insuline-potassium (GIK) onthe left ventricular function (+dp/dt-max,LVSP) were evaluated in dogs with acute myocardial in-farction (AMI) for 6 hours. All the animals were anesthetized,ched opened and ventilated with pureoxygen. In the group of isovolumetric hemodilution or GIK infusion, +dp/dt-max increased,as com-pared with that in the control group (no treatment was given after occlusion) (P<0. 05). GIK infu-sion came into effect later than the former. In the group of the combination of the two therapies,LVSPand dp/dt-max were elevated,as compared with either of the two groups which were affected by onlyone therapy (P<0. 05). The results suggested that isovolumetric hemodilution with dextran 40 andGIK infusion both could significantly improve the left ventricular contractility in the early phase ofAMI, that GIK infusion mighf produce effect slower, and that the combination of the two therapiescould not only further improve the left ventricular contractility,but also enhance the relaxation signifi-cantly. It was demonstrated that the combination showed obvious coordinated effects.