巯甲丙脯酸及硫酸镁对再灌注后顿抑心肌功能的影响

Effect of Captopril and Magnesium on Cardiac Function Recovery after Myocardial Reperfusion

目的:顿抑心肌功能的及早恢复,对防止心梗后心衰、心源性休克等并发症具有重要意义,由于再灌注疗法对顿抑心肌功能无明显作用,能否选用影响顿抑心肌产生机制的药物如巯甲丙脯酸(captopril,Cap)及硫酸镁(magnesium,Mag)结合再灌注疗法来促进其恢复过程值得研究。方法:利用实验动物犬二期阻闭+再灌注心肌梗塞模型对 Mag 及 Cap 在再灌注后顿抑心肌功能恢复上的影响进行了观察,结果利用精确概率计算法、方差分析及 t 检验进行统计学分析。结果:Mag、Cap、对照组心梗范围分别为(24.57±0.8)%,(16.31±1.7)%,(30.03±3.26)%。在再灌注期 Mag 组心输出量有所恢复,而对照组、Cap 组再灌注期前后无显著改变。结论:预防性使用 Mag 及 Cap 可限制心肌梗塞范围,使更多的心肌仅处于缺血状态。Mag 结合再灌注有助于这些缺血心肌的功能恢复,使心输出量上升,Cap 则无此作用。

Objective:Early recovery of stunned myocardium is a important role for preventing heart failture and cardiogenic shock post myocardial infarction.It is demonstrated that reperfusion has no effects on the function recovery of stunned myocardium,it is valuable to research weither using drugs such as captopril and magnesium which influnce the mechanism of stunned myocardium formation during repeffu- sion may promote the function recovery or not.Methods:This study using canine myocardial infarction modal caused by two-stage ligation of left descending coronary artery followed by reperfusion observed the effect of magnesium and captopril on the function recovery of stunned myocardium,statistics analysis was carried out by means of ANOV and T test.Results:The results showed that infarct size in group magne- sium,captopril and control were(24.57±0.8)%,(16.31±1.7)%,(30.03±3.26)% respectively. The cardic output in group magnesium during reperfusion incresed but group captopril and control not. Conclusion:Prophylactic use of captopril and magnesium could limit the infarct size and result in more myocardium at ischemic stage other than death;magnesium sulfate was helpful for the stunning myocardi- um to recover its insufficient function after reperfusion,but captopril had no the effect.