小、中剂量阿司匹林对AMI的疗效及其与抗炎作用的关系

The therapeutic effects of low-and moderate-dose aspirin on rabbits with experimental acute myocardial infarction and their relationship with antinflammation

目的 :评价小、中剂量阿司匹林对急性心肌梗死 ( AMI)的治疗作用及其机制。方法 :将体质量 1.5～ 2 .5 kg的成年兔 3 6只随机分为对照组 ( A组 )、阿司匹林小剂量组 ( B组 )及中剂量组 ( C组 ) ,建立 AMI模型并给予相应的干预 ,术后 6h作血液学观察 ,4d及 4周时分别作血液、血清、血流动力学、大体形态测量及组织学的观察。结果 :B,C组与 A组比较 ,术后 6h血白细胞数无明显差异 ( P>0 .0 5 ) ,而 4d及 4周时明显下降 ( P<0 .0 5 ) ,一氧化氮在术后4d及 4周时均无明显差异 ( P>0 .0 5 ) ,心房钠尿肽、左室功能测定值、左室舒张末压均明显下降 ( P<0 .0 5 ) ,术后 4d梗死面积明显下降 ( P<0 .0 5 ) ,但 4周时修复后瘢痕的面积无明显差异 ( P>0 .0 5 ) ,以上指标 B、C组间无明显差异 ( P>0 .0 5 )。 4周时 B组瘢痕厚度与 A组无明显差异 ( P>0 .0 5 ) ,但 C组厚度明显变薄 ( P<0 .0 5 )。组织学检查显示 A组梗死区术后 4d心肌结构消失 ,中性粒细胞大量浸润 ,B,C组白细胞浸润程度与 A组无明显差异 ,但 B组梗死区中有少许坏死心肌组织 ,C组则残存较多的坏死心肌组织。结论 :小剂量阿司匹林对

AIM: To investigate the mechanism underlying the effects of low and moderate dose aspirin on rabbits with experimental acute myocardial infarction and their clinical significance. METHODS: Adult rabbits (weight:1.5～2.5 kg, n =36) were randomLy divided into three groups: group A undergoing all procedures except treatment, group B receiving the treatment of low dose aspirin, group C receiving the treatment of moderate dose aspirin. The specimens harvested at 6 hours, 4 days and 4 weeks after AMI, were measured and studied under the microscope. RESULTS: The blood leukocyte count in the three groups were similar at the first 6 hours after AMI, but those in group B, C were significantly reduced compared with those in group A 4 days and 4 weeks after AMI. In group B and C, NO was similar to that of group A, but ANP, STI, LVEDP were significantly decreased compared with those of group A. Myocardial infarct sizes in group B and C were significantly decreased 4 days after AMI, while were similar to group A 4 weeks after AMI. Scar thickness in group B did not differ from that in group A, but in group C the scar thickness was thinner than that in group A 4 weeks after AMI. Light microscopic examination of myocardial infarct area revealed similar leukocytic infiltration in three groups, with no structure of necrotic myocardium in group A, a little in group B and much in group C 4 days after AMI. CONCLUSION: The theraputic effects of aspirin in a low dose on AMI may be better than that in a moderate dose.