气动泵对急性左侧心力衰竭辅助时神经体液因子的影响

Effect of Assisted Pneumatic Pulsatile Sac type Pump on Neurohormone in Acute Left Sided Heart Failure

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摘要目的　探讨气动泵对急性左侧心力衰竭不同流量辅助时内皮素、一氧化氮、血浆肾素、血管紧张素Ⅱ的影响。　方法　对２０条急性左侧心力衰竭犬随机分成４组：Ⅰ组：低流量辅助（５０ｍｌ／ｋｇ·ｍｉｎ）；Ⅱ组：中流量辅助（７０ｍｌ／ｋｇ·ｍｉｎ）；Ⅲ组：高流量辅助（９０ｍｌ／ｋｇ·ｍｉｎ）；Ⅳ组：对照组。对４组分别进行高、中、低流量的１８０分钟左心室辅助，观察其对血流动力学和神经体液因子的影响。　结果　左心室辅助循环可使急性左侧心力衰竭犬肺毛细血管嵌压、血浆肾素、血管紧张素Ⅱ、内皮素迅速下降，平均主动脉压、心脏指数、左心室做功指数、一氧化氮均升高（Ｐ＜０－０５）。　结论　不同辅助流量对急性左侧心力衰竭时左心功能支持均有效，但以中、高流量效果最佳。 Objective To study influence of plasma renin activation,angiotension Ⅱ,nitric oxide and endothelin on acute left ventricular failure of the dog using different assisting flow rate of pneumatic pulsatile sac type pump. Methods Twenty dogs were divided into four groups. Ⅰ group: the low flow rate (50ml/kg·min),Ⅱ group:the median flow rate (70 ml/kg·min),Ⅲ group:the high flow rate (90ml/kg·min)and Ⅳ group:the control group.Acute left ventricular failure model in the dog was set up left ventricular assist circulation with a pneumatic pulsatile sac type pump by high,median and low flow rate were carried out.The changes of hemodynamics and neuroendocrine activation were observed in conditions of different degree of flows during a period of 180 minutes. Results The pulmonary capillary wedged pressure,plasma renin activity,angiotension Ⅱ,endothelin rapidly lowered, mean aortic pressure,cardiac index,left ventricular work index and nitric oxide rose during left ventricular assist circulation. Conclusion It is beneficial to use left ventricular assist device in different rate of flow in condition of acute left heart failure ,but with best effect in the median and high flow rate.