消心痛对犬右心室梗死心源性休克血浆心钠肽水平的影响

Effect of isosorbide dinitrate on the concentration of atrial natriuratic peptide in cardiac shock induced by right ventricular myocardial infarction in dogs

目的观察犬右心室心肌梗死(RVMI)心源性休克时的血浆心钠肽(ANP)水平变化及单纯补液、消心痛治疗对其影响。方法结扎犬心冠状动脉,造成RVMI并发心源性休克模型,随机分为对照组、补液组、消心痛组。放免法测定各组正常时、模型成功后即刻及治疗后即刻、1h、3d、1周的血浆ANP水平变化及血流动力学变化。结果模型成功后,血浆ANP水平明显升高;快速补液后即刻,ANP升高,但不如消心痛组明显,而后逐渐继续升高,并于治疗后3d达高峰。消心痛组治疗后即刻ANP即明显升高并达高峰,此后逐渐下降,于治疗后3d时各组无统计学差异。结论RVMI并发心源性休克时,消心痛可促进ANP的释放,降低右心后负荷,对纠正心源性休克有益。

Objectives To evaluate the neuroendocrine effect of ISDN on cardiac shock induced by right ventricular myocardial infarction in dogs. Methods RVMI models were completed through ligating coronary artery. Dogs were divided into three groups（control, volume loeding and ISDN. The hemodynamic indication included mean artery pressure（MAP）, right atrial pressure（RAP） ,left ventricular end diastolic pressure[ LVEDP） and cardiac output（CO）. The neuroendocrine indication include atrial natriuretie peptide（ANP）. The indications were measured at 0 rain after the models were completed,0 min,60 mins,three days andone week after the therapy were completed. Results After the models were completed, serum ANP concentrations were incresed significantly. After the volume loading therapy immediately, serum ANP concentrations were increased, but they were lower than that of ISDN group and reached the peak at three days after the treatment. The ANP concentration increased apparently and reached the peak after the ISDN treatment immediately, then decreased gradually. Conelusions The ISDN therapy can promote the secretion of ANP, it is beneficial in cardiac shock induced by RVMI.