应用7种解痉挛药物预防去甲肾上腺素诱发的 血管痉挛的疗效比较

Comparison of the efficacy of seven antispasmodic drugs in the prevention of norepinephrine-induced vasospasm

目的探讨使用解痉药物预防去甲肾上腺素诱发的血管痉挛。方法64只SD大鼠随机分为8组,在其股动静脉区域滴加7种解痉挛药剂预处理30min(前列腺素E1、硝普钠、硫酸镁、罂粟碱、酚妥拉明、维拉帕米和利多卡因),生理盐水作为对照组。随后分别滴加去甲肾上腺素0.1m(l1:1000),建立血管痉挛模型。通过激光散斑血流成像系统监测股动静脉灌注强度和内径,数据处理为血流灌注。采用单因素方差分析进行组间股血管灌注差异比较。结果对照组(生理盐水)局部应用去甲肾上腺素5 min,动脉灌注约降低91%,静脉灌注约降低78%。硝普钠和酚妥拉明组均可预防股动静脉血管痉挛(P<0.05),罂粟碱仅对股动脉痉挛有预防作用,前列腺素E1仅对股静脉有预防痉挛的作用。结论术前使用硝普钠和酚妥拉明预处理血管,可以预防去甲肾上腺素诱发的动静脉痉挛。其中硝普钠预防效果最强,酚妥拉明效果次之。

Objective To explore the use of antispasmodic drugs to prevent norepinephrine-induced vasospasm.Methods Sixty-four SD rats were randomly divided into 8 groups.The rats were pretreated with 7 kinds of antispasmodic drugs for 30 minutes(Prostaglandin E1,sodium nitroprusside,magnesium sulfate,papaverine,phentolamine,verapamil and lidocainehydrocloride).Normal saline was used as a control agent.Then 0.1 ml norepinephrine(1:1000)was added to trigger vasospasm.The perfusion intensity and diameter of the femoral artery and vein were monitored by a laser speckle blood flow imaging system.Spss19.0 was used to compare the perfusion difference between groups.Results In the control group(normal saline),local application of norepinephrine for 5 minutes reduced arterial perfusion by 91%and venous perfusion by 78%.Both sodium nitroprusside and phentolamine could prevent the vasospasm of femoral artery and vein(P<0.05);papaverine only prevented the spasm of the femoral artery,and prostaglandin E1 only prevented the spasm of the femoral vein.Conclusions Pretreatment with sodium nitroprusside and phentolamine can prevent norepinephrine-induced vasospasm.Sodium nitroprusside has the strongest preventive effect,followed by phentolamine.