west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "心肌顿抑" 4 results
  • The Protective Effect of Myocardial Hibernation Induced by D-Ala(2),D-Leu(5) Enkephalin on Myocardial IschemiaReperfusion Injury of Rabbits in Vitro

    Objective To investigate whether the agonist of delta opoid receptor D-Ala(2),D-Leu(5) enkephalin (DADLE) has the effect of decreasing myocardial injury during ischemia-reperfusion of adult rabbits’ myocardium,so that a new mehanism and way to myocardial protection could be found. Methods Langendorff model was used during the experiment. Thirty rabbits were divided into three groups randomly (each group 10 rabbits). Control group: St.Thomas Ⅱ cardioplegic solution was used; group 1: St.Thomas Ⅱ cardioplegic solution and DADLE (1mg/kg) were used; group 2: St.Thomas Ⅱ cardioplegic solution and naloxone(3mg/kg) were used to induce the hearts to arrest respectively. After arrest the hearts were reperfused respectively. Data of left ventricle development pressure(LVDP) was recorded before and after ischemia. Biochemical indicators of myocardium, lactate dehydrogenase(LDH) were detected before and after ischemia. Some myocardial tissues were used to explore the changes of the tissue of ultrastructure with electron microscope,when the experiment was over. Still some myocardial tissues were to be detected by flow cytometer to evaluate the apoptosis of the myocardium. Results The LDH and LVDP showed significant difference among three groups after ischemia(Plt;0.05); LVDP in group 1 was higher than those in group 2 and control group(69.8±5.8 mmHg vs. 23.4±3.9 mmHg; 69.8±5.8 mmHg vs. 37.9±4.7 mmHg; Plt;0.05), the LDH in group 1 was lower than those in group 2 and control group(1 272.6±59.1 U/L vs. 2 764.4±27.7 U/L, 1 272.6±59.1 U/L vs. 1 884.4±37.5 U/L; Plt;0.05). The apoptosis rate in group 1 was lower than those in group 2 and control group. As could be shown from the ultrastructure: mitochondria structure was nearly normal in group 1; mitochondria structure was injuried severely in group 2; there was a minor injury in control group. Conclusion Agonist of δ opoid receptor DADLE in cardioplegic solution could induce hibernation, which has myocardial protection effect during ischemia-reperfusion injury.

    Release date:2016-08-30 06:04 Export PDF Favorites Scan
  • 心瓣膜置换术后早期心肌顿抑致低心排血量综合征的诊治经验

    目的 探讨心瓣膜置换术后早期心肌顿抑的识别、诊断,以及由此导致严重低心排血量综合征(LCOS)的治疗方法,以提高诊断、治疗水平。 方法 回顾分析我科2004年9月至2006年9月期间4例心瓣膜置换术后早期出现心肌顿抑导致LCOS患者的临床资料,4例均为女性,年龄35~54岁,平均年龄46-75岁。术前左心室大小、收缩功能均基本正常,左心室舒张期末内径(LVEDD)3.5~6.3 cm,射血分数(EF)49%~61%;2例行二尖瓣、主动脉瓣置换术,1例行二尖瓣置换术,1例行主动脉瓣置换术。 结果 4例患者均在术后早期(14~40 h、平均26 h)出现无明确原因的LCOS,给予大剂量肾上腺素[0.10~0.15 μg/(min·kg)]治疗无效而改行主动脉内球囊反搏(IABP)治疗,4例患者IABP支持时间为7~12 d(平均8.5 d),3例痊愈,1例因肺部感染于术后28 d死于多器官功能衰竭。2例出现急性肾功能不全,1例7 d后肾功能恢复正常,1例经腹膜透析治疗2周后痊愈。 结论 心肌顿抑可出现在术前心功能良好,手术经过顺利的心瓣膜置换术患者,由心肌顿抑导致的术后早期LCOS,及时应用IABP可以减轻心脏负荷,增加冠状动脉灌注,改善重要脏器循环,有助于左心室渡过心肌顿抑期,恢复收缩功能,是成功救治的重要手段。

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • Advances in Research of Molecular and Cellular Mechanisms of Myocardial Stunning

    Myocardial stunning is the main pathological basis of heart dysfunction after open heart operation, its exact pathogenesis hasn’t been clarified until today.In recent years,the molecular and cellular studies have revealed possibly crucial pathogenesis of myocardial stunning that delayed recovery of myocardial glucose oxidation causes intracellular H + accumulation which augments H + Na + exchange thus leading to [Na +] i overload.[Na +] i overload increases Na + Ca 2+ exchange resulting in t...

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • 心脏直视手术后早期心肌顿抑的诊断与治疗

    目的探讨心脏瓣膜置换术后早期心肌顿抑的诊断及治疗以及其所引起的低心排血量综合征(LCOS)的诊疗。 方法回顾性分析我院 2011 年 1 月至 2018 年 3 月期间 42 例心脏瓣膜置换术后早期出现心肌顿抑导致 LCOS 患者的临床资料,其中男 19 例、女 23 例,年龄 38~55(47.91±5.51)岁。术前左心室舒张末期内径(LVEDD)3.8~6.5(5.3±0.9)cm,左心室射血分数(EF)45%~60%(51.2%±5.3%);冠状动脉粥样硬化性心脏病筛查均为阴性;其中单纯主动脉瓣置换 12 例,二尖瓣置换合并三尖瓣成形 15 例,二尖瓣和主动脉瓣置换 15 例。 结果42 例患者均在术后早期[10~24(18.83±4.24)h]出现无明确原因的 LCOS,大剂量肾上腺素[0.06~0.10 μg/(kg·min)]和去甲肾上腺素[0.1~0.5 μg/(kg·min)]治疗无效而加用主动脉内球囊反搏(IABP)治疗,其中 25 例患者行肾脏替代治疗(CRRT)。IABP 辅助时间 3~10(5.16±1.95)d,CRRT 治疗时间 22~61(42.17±10.75)h。40 例患者痊愈出院,2 例患者院内死亡,1 例死于脓毒血症,1 例患者死于恶性心律失常。 结论心脏瓣膜置换术后早期出现心肌顿抑引起病情突变恶化,如能早期诊断、早期治疗,将取得好的临床结果。IABP 可以减轻心脏负荷,增加冠状动脉灌注,改善循环,有助于患者渡过心肌顿抑期;CRRT 可以改善 LCOS 患者内环境,减轻肾脏负担。两者是成功救治此类患者的重要手段。

    Release date:2019-03-01 05:23 Export PDF Favorites Scan
1 pages Previous 1 Next

Format

Content