摘要
目的观察抗交感神经兴奋治疗策略对颅内动脉瘤蛛网膜下腔出血并心肌损伤的影响。方法将60只颅内动脉瘤蛛网膜下腔出血合并心肌损伤日本大耳白兔随机分为对照组、倍他乐克组、右美托咪定组、联合组,每组15只。另选择正常日本大耳白兔15只作为正常组。对照组每天经耳缘静脉静滴生理盐水;倍他乐克组经胃管给予倍他乐克,连续2周;右美托咪定组经耳缘静脉泵入右美托咪定,连续3周;联合组经胃管给予倍他乐克和耳缘静脉泵入右美托咪定。5组分别于干预前及干预1,2,3周后行心脏超声检查测定左室收缩末期内径(LVESD)、左室射血分数(LVEF),酶联免疫吸附法测定血浆去甲肾上腺素(NE)、肾上腺素(E)浓度;干预3周后处死动物,染料法荧光定量测定兔心肌局部组织中β2肾上腺素能受体mRNA表达情况。结果干预1周后,造模4组实验动物血浆NE、E浓度及LVESD、LVEF均明显高于干预前(P均<0.05);干预3周后,造模4组实验动物血浆NE、E浓度及LVESD均明显低于干预2周后(P均<0.05),LVEF均明显高于干预2周后(P均<0.05),且倍他乐克组、右美托咪定组及联合组上述指标改善情况均明显优于对照组(P均<0.05),联合组改善情况明显优于倍他乐克组、右美托咪定组(P均<0.05),倍他乐克组与右美托咪定组比较差异无统计学意义(P均>0.05)。干预3周后,联合组局部心肌组织中β2肾上腺素能受体mRNA表达量均明显低于对照组、倍他乐克组、右美托咪定组(P均<0.05),与正常组比较差异无统计学意义(P均>0.05)。结论抗交感神经兴奋治疗可改善颅内动脉瘤蛛网膜下腔出血合并心肌损伤动物心功能,右美托咪定与倍他乐克联合应用效果更佳。
Objective It is to observe the effect of treatment strategies with resistance of sympathetic nerve excitement for intracranial aneurysm subarachnoid hemorrhage with myocardial injury. Methods 60 Japanese big ear rabbits with intracranial aneurysm subarachnoid hemorrhage with myocardial injury were randomly divided into control group given normal saline by in-travenous drip from ear vein every day, betaloc group treated with betaloc by lavage for 2 weeks, Dexmedetomidine group trea-ted with Dexmedetomidine by Intravenous pump from ear vein for 3 weeks, Dexmedetomidine and betaloc group （ combination group） treated with both drugs by the same method, each group had 15 ones, 15 normal Japanese big ear rabbits were selected as normal group. Before intervention and after 1,2, 3,weeks’ intervention, LYESD and LYEF were detected by cardiac ul-trasonography ,the plasma contents of NE and E were determined by ELSIA. After 3 weeks’ treatment, all the animals were put to death to detect the expression of beta 2 adrenergic receptor mRNA in myocardial local tissue by dye fluorescence quanti-tative method. Results After intervention for 1 weeks, plasma contents of NE, E and LYESD, LYEF were higher than that be-fore intervention in the four modeling groups （ F 〈 0. 05 ） after intervention for 3 weeks, the contents of NE, E and LYESD were lower while LYEF was higher than that after intervention for 2 weeks （ F 〈 0. 05 ） , and the improvements in betaloc group, Dexmedetomidine group and combination group were better than that in control group （P 〈0. 05）,and the improve-ments in combination group were the best （P 〈 0. 05） , no difference was found between betaloc group and Dexmedetomidinegroup （P 〉 0. 05）. After intervention for 3 weeks, the expression of beta 2 adrenergic receptor mRNA in myocardial local tis-sue in combination group was lower than that control group, betaloc group, Dexmedetomidine group（ P 〈 0. 05 ） , but no differ-enc
出处
《现代中西医结合杂志》
CAS
2017年第25期2740-2743,共4页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
湖北省自然科学基金面上项目(2014CFB314)
关键词
右美托咪定
蛛网膜下腔出血
心肌损伤
Dexmedetomidine
subarachnoid hemorrhage
myocardial injury
