摘要
目的 观察尿激酶联合应用选择性内皮素-1受体拮抗剂BQ-123对急性肺栓塞继发心肌缺血损伤的保护作用.方法 20条Beagle犬随机分为5组：假手术组（Sham组）、肺栓塞组（PE组）、尿激酶溶栓组（UK组）、BQ-123组（BQ组）、尿激酶±BQ-123联合组（UK± BQ组）,每组4条.测量各组栓塞前、栓塞后或溶栓后2.0、4.0、6.0h肺动脉平均压（mPAP）、冠状动脉血流量以及栓塞后6h血清肌钙蛋白T（cTnT）含量.结果 （1）肺栓塞0.5h后mPAP显著升高,接受尿激酶、BQ-123治疗后UK组与UK± BQ组mPAP下降,栓塞后4h分别为（26.67 ±2.08）、（20.00±2.00） mmHg（1 mmHg=0133 kPa）,显著低于PE组[（37.33 ±4.16） mmHg,P＜0.05];（2）栓塞后6h,UK± BQ组血清cTnT值（611.93 ±97.50） ng/L小于UK组（747.22±62.72） ng/L和PE组[（900.79 ±71.11） ng/L,P＜0.05];（3）冠状动脉血流量显示：PE组下降,UK、BQ、UK＋ BQ组不同程度增加,其中UK＋ BQ组增加更明显（P＜0.05）.结论 在溶栓治疗基础上联合应用内皮素-1受体拮抗剂BQ-123能显著降低肺动脉压力、增加冠状动脉血流量,极大程度上缓解急性肺栓塞继发急性心肌缺血损伤.
Objective To observe the effect of the selective endothelin receptor antagonist BQ-123 combined with urokinase against myocardial injury due to acute pulmonary embolism （APE）.Methods Twenty healthy adult Beagle dogs were used,and randomly assigned to five groups：sham-operated group （sham group）,pulmonary embolism group （PE group）,urokinase thrombolysis grouop （UK group）,BQ123 group （BQ group） and urokinase ＋ BQ-123 combination group （UK ＋ BQ group）,with 4 dogs in each group.The parameters of the mean pulmonary artery pressure （mPAP）,and coronary blood flow （CBF） at different time pointi pre-and post-embolization were recorded and compared,and the serum cTnT level at 6 h post-embolization was determined.Results （1） After pulmonary embolism,mPAP was obviously increased,and at 4 h,mPAP in UK group and UK ＋ BQ group was decreased to （26.67 ± 2.08） and （20.00 ± 2.00） mmHg （1 mmHg =0133 kPa） respectively,remarkably lower than that in PE group （P 〈 0.05） ; （2） The serum cTnT level at 6 h post-embolization in UK ± BQ group [（611.93 ±97.50） ng/L] was significantly lower than that in UK group [（747.22 ± 62.72） ng/L] and PE group [（900.79 ± 71.11） ng/L] （P 〈0.05） ; （3） The CBF in PE group was obviously declined,and in UK group,BQ group and UK ＋ BQ group,the CBF was increased to varying degrees.UK ＋ BQ group had the greatest increase of CBF and showed statistically significant difference from the other two groups at different time points post-embolization （P 〈 0.05）.Conclusion On the basis of thrombolysis therapy,endothelin-1 receptor antagonist BQ-123 can increase the CBF significantly and relieve the acute myocardial ischemia induced by APE.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2014年第10期2214-2216,共3页
Chinese Journal of Experimental Surgery
基金
全军医学科技“十二五”科研面上项目（CWS11J019）
关键词
肺栓塞
内皮素受体拮抗剂
溶栓
肌钙蛋白T
心肌缺血
Pulmonary embolism
Endothelin receptor antagonist
Thrombolysis
Troponin T
Myocardial ischemia
