摘要
目的探讨巴尼地平,氨氯地平和缬沙坦在它们各自血浆游离治疗浓度下对急性心肌缺血与再灌注心律失常发生的作用。方法用兔左心室冠状动脉灌流楔形标本作为急性心肌缺血与再灌注的模型,记录跨壁心电图和心肌收缩力。并对心肌缺血后再灌注静脉流出液的乳酸浓度进行测量。在进行急性心肌缺血30 min之前,给兔左心室冠状动脉灌流楔形的灌流液中分别加入巴尼地平、氨氯地平和缬沙坦。总缺血时间为40 min,然后再灌注10 min。巴尼地平、氨氯地平和缬沙坦的作用与同一时间匹配的对照组相比。结果巴尼地平(0.2 nmol/L)、氨氯地平(1.5 nmol/L)和缬沙坦(2μmol/L)对正常灌流兔左心室楔形标本QRS间期,QT间期以及频率依赖性心肌收缩力正阶梯效应无显著影响。巴尼地平组,急性心肌缺血与再灌注的室性早搏,室性心动过速(VT)或心室颤动发生率显著减少。心肌缺血与再灌注时,巴尼地平组的7个标本0例(0/7)发生了VT或心室颤动;对照组10个标本在心肌缺血时5个标本(5/10)以及在再灌注时7个标本(7/10)发生了VT或心室颤动(P<0.01)。巴尼地平减小室性早搏、VT或心室颤动的趋势比氨氯地平和缬沙坦更为明显。巴尼地平也显著减少急性心肌缺血后再灌注乳酸的释放。结论与氨氯地平和缬沙坦相比,巴尼地平对缺血与再灌注心肌有更加显著的保护作用,其结果减少急性心肌缺血与再灌注心律失常的发生。
Objective To investigate the effects of barnidipine, amlodipine and valsartan on arrhythmia during acute myocardial ischemia and reperfusion at their respective plasma free therapeutic concentration. Methods An isolated wedge-shaped specimen of left ventricular coronary perfusion in rabbits was used as the model of acute myocardial ischemia and reperfusion. Transmural ECG and myocardial contractility were recorded. The concentration of lactic acid in venous effluent during myocardial ischemia and reperfusion was detected. Thirty minutes before acute myocardial ischemia, barnidipine, amlodipine and valsartan were added respectively to the rabbit ventricular wedge preparations. The time of ischemia was 40 min and the reperfusion was 10 min. The effects of these three drugs were compared with that of the time-matched control group. Results At normal perfusion, barnidipine at 0.2 nmol/L, amlodipine at 1.5 nmol/L, and valsartan at 2 μmol/L exerted no significant effect on QRS duration, QT interval and the frequency-dependent positive staircase response of myocardial contractility in wedge-shaped left ventricular specimens. After acute myocardial ischemia and reperfusion, the incidence of ventricular premature beats, ventricular tachycardia(VT) or ventricular fibrillation(VF) was significantly reduced in the barnidipine group. VT or VF occurred in 0 of 7(0/7) specimens in barnidipine group, 5 of 10(5/10) specimens in control group and 7 of 10(7/10) specimens in reperfusion group(P<0.01) during myocardial ischemia and reperfusion. Compared with amlodipine group and valsartan group, barnidipine more significantly decreased the incidence of ventricular premature beats, VT or VF. Barnidipine also significantly reduced the release of lactate during acute myocardial ischemia and reperfusion. Conclusion Compared with amlodipine and valsartan, balidipine exerts a more significant protective effect on ischemia and reperfusion myocardium, which reduced the incidence of arrhythmias during acute myocardial ischemia and reperfusio
作者
薛小临
舒娟
刘腾先
严干新
XUE Xiao-lin;SHU Juan;LIU Teng-xian;YAN Gan-xin(Department of Carcliovascutar Medicine , First Affiliated Hospital of Xi'an Jiaotong University, the First Affiliated Hospital, Xi'an Jiaotong University , Xi'an Shaanjci 710000 ,China)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2019年第4期356-361,共6页
Chinese Journal of Hypertension
关键词
巴尼地平
氨氯地平
缬沙坦
心肌缺血
再灌注
barnidipine
amlodipine
valsartan
myocardial ischemia
reperfusion
