中药通心络(超微粉碎)对猪急性心肌梗死再灌注后无再流的影响

Effect of Tongxinluo Ultramicro-pulverization on Myocardial Post-reperfusion No-reflow in Mini-Swine Model of Acute Myocardial Infarction

目的评价通心络(超微粉碎)防治猪急性心肌梗死(AMI)再灌注后无再流的作用。方法中华小型猪40只随机分为对照组,小剂量(0·05g/kg·d)、中剂量(0·2g/kg·d)、大剂量(0·5g/kg·d)通心络(超微粉碎)组和假手术组,每组8只。治疗组预给药3天后行冠状动脉结扎3h,松解1h制备AMI再灌注模型。AMI前后和再灌注后均行血流动力学测定和心肌声学造影(MCE)检查,最终行病理学分析。结果与对照组比较,小、中和大剂量通心络(超微粉碎)可改善再灌注后的心功能,分别减少无再流面积由对照组的(78·5±4·4)%和(82·3±1·9)%至(43·4±3·2)%和(44·6±3·3)%,(25·2±2·4)%和(25·7±4·0)%,(24·0±1·9)%和(24·9±4·2)%(P<0·05或P<0·01),分别减少心肌梗死面积由对照组的(98·5±1·4)%至(89·8±4·6)%,(80·2±3·1)%和(79·9±3·1)%(P<0·05或P<0·01)。结论通心络(超微粉碎)能有效地防治心肌梗死再灌注后无再流,缩小梗死面积。

Objective To assess the effect of Tongxinluo （TXL） ultramicro-pulverization in preventing and treating post-reperfusion no-reflow in mini-swine model of acute myocardial infarction. Methods Forty mini- swines were randomly divided into 5 groups, the control group, the three （low-, middle- and high-dose） TXL groups and the sham-operation group, with 8 in each group. After pigs in the three TXL groups were administered with TXL in a dose of 0.05g/kg, 0.2g/kg and 0.Sg/kg once a day for 3 days respectively, they were made into acute myocardial ischemia/reperfusion model by ligating left anterior descending coronary artery for 3h followed with lh of untying. Hemodynamic examination and myocardial contrast echocardiography （MCE） were conducted before and after ligation, and after reperfusion, finally, pathological analysis was done. Results Post-reperfusion ventricular function injury was significantly improved in the three TXL groups, as compared with the control group, the no-reflow area determined by hemodynamic and MCE decreased from 78.5± 4.4 % and 82.3 ± 1.9% in control to 43.4± 3.2% and 44.6 ± 3.3% （low-dose）, 25.2 ± 2.4% and 25.7 ± 4.0% （middle-dose）, 24.0± 1.9% and 24.9_±4.2% （high-dose）, respectively （P〈0.05 or P〈0.01）, and the myocardial infracted area was reduced from 98.5 ± 1.4 % to 89.8 ± 4.6 %, 80.2 ± 3.1% and 79.9 ± 3.1%, respectively （P〈 0.05, P 〈 0.01）. Conclusion TXL ultramicro-pulverization can effectively prevent and treat no-reflow after myocardial acute infarction following reperfusion, and reduce the infracted area.