Neugebauer G
Z Kardiol. 1976 Nov;65(11):1010-21.
Reduction of blood viscosity by arwin in the acute experimental infarction. The effect of 1 unit/kg arwin on the extent of the ischemic area following ligation of a branch of the left descending coronary artery (LAD) was studied in 13 anesthetized open-chest dogs. 10 min infusion of Arwin veginning simultaneously with coronary occlusion lead to a decrease in plasma fibrinogen concentration by 69% 60 min after the end of the infusion, whereas in the control group (NaCl-infusion, 13 dogs) no equivalent decrease occurred. The average ST-segment elevation (ST) and the number of sites exhibiting ST-segment elevation (NST) in the epicardial Ecg were 9 mV and 5.0 15 min after the end of the infusion (25 min after coronary occlusion) in the Arwin-treated group and 11 mV resp. 5.9 in the control group. In the following 105 min no alteration in the electrocardiographic evidence of infarction occurred in both groups. 15 min reperfusion (after release of coronary ligation) decreased the ischemic injury in both groups significantly: arwin -group ST 4.1 mV, NST 3.0, control 3.9 mV resp. 3.5. During coronary occlusion ST-elevation was significantly less in borderline areas than in the center of the infarction, a reduction of the ischemic injury by arwin in these different zones, however, could also not be established. Hemodynamic alterations were similar in both groups. Systolic, mean and diastolic aortic pressure, left ventricular systolic pressure and heart rate remained nearly constant during 130 min of coronary occlusion, left ventricular dp/dtmax declined by 17%. 25 min after occlusion of the branch coronary flow in the LAD decreased by 38%, after 130 min by 48%. After 15 min reperfusion the reactive hyperemic response had declined to preocclusion levels. A statistically significant difference in the occurence of reperfusion arrhythmias between the arwin -treated group (25%) and control group (39%) could not be evaluated. There was no evidence that a decrease in blood viscosity produced by lowering of fibrinogen concentration concomitantly with coronary occlusion could reduce electrocardiographic assessment of myocardial injury. Conversely, the effects of arwin on impending infarction and severe angina pectoris cannot be predicted from these results. An increase in infarct size, however, which could have occurred after infusion of arwin leading to microembolization by fibrinogen degradation products was never observed.
阿魏宁在急性实验性梗死中对血液粘度的降低作用。在13只麻醉开胸犬中研究了1单位/千克阿魏宁对结扎左冠状动脉前降支(LAD)分支后缺血区域范围的影响。在冠状动脉闭塞同时开始10分钟输注阿魏宁,输注结束后60分钟血浆纤维蛋白原浓度降低69%,而在对照组(输注生理盐水,13只犬)未出现同等程度的降低。在阿魏宁治疗组,输注结束后15分钟(冠状动脉闭塞后25分钟),心外膜心电图的平均ST段抬高(ST)和出现ST段抬高的部位数量(NST)分别为9mV和5.0,对照组分别为11mV和5.9。在接下来的105分钟内,两组梗死的心电图表现均无改变。15分钟再灌注(冠状动脉结扎解除后)两组缺血损伤均显著减轻:阿魏宁组ST为4.1mV,NST为3.0,对照组分别为3.9mV和3.5。在冠状动脉闭塞期间,梗死边缘区域的ST段抬高明显低于梗死中心,但也无法确定阿魏宁在这些不同区域对缺血损伤的减轻作用。两组血流动力学改变相似。在130分钟冠状动脉闭塞期间,主动脉收缩压、平均压和舒张压、左心室收缩压和心率几乎保持恒定,左心室dp/dtmax下降17%。LAD分支冠状动脉血流在闭塞25分钟后减少38%,130分钟后减少48%。15分钟再灌注后,反应性充血反应降至闭塞前水平。无法评估阿魏宁治疗组(25%)和对照组(39%)再灌注心律失常发生率的统计学显著差异。没有证据表明冠状动脉闭塞时纤维蛋白原浓度降低导致的血液粘度降低能减少心肌损伤的心电图评估。相反,从这些结果无法预测阿魏宁对即将发生的梗死和严重心绞痛的作用。然而,从未观察到因输注阿魏宁导致纤维蛋白原降解产物微栓塞后梗死面积增加的情况。