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缺血诱导的心肌阳离子电解质紊乱的时程和区域变化。

Time course and zonal variations of ischemia-induced myocardial cationic electrolyte derangements.

作者信息

Lie J T, Pairolero P C, Holley K E, McCall J T, Thompson H K, Titus J L

出版信息

Circulation. 1975 May;51(5):860-6. doi: 10.1161/01.cir.51.5.860.

Abstract

Myocardial cationic electrolytes were determined at regular time intervals up to 24 hours after coronary artery ligation in the dog. Replicate electrolyte ratios were computed for different areas of the heart at each time interval. For purposes of statistical analysis, ratios from two border areas and four areas remote from the infarct were pooled as values for ZONE B and ZONE N, respectively, and compared with those from the infarct proper, ZONE I. Ischemia-induced tissue Mg++/Ca++ changes paralleled those of K+/Na+ with respect to time course and zonal variations. In ZONE I, both K+/Na+ and Mg++/Ca++ fell precipitously during the first hour, and the falls became more gradual thereafter, approac hing those of extracellular fluid at 24 hours. Changes in ZONE B, which appeared normal histologically, followed a similar downward trend but differed in magnitude from those in ZONE I (P smaller than 0.01). Changes in ZONE N were small but did not always overlap values in sham-operated dogs. It was concluded that lowered tissue K+/Na+ and Mg++/Ca++ were sensitive, but not specific, indices of myocardial ishemia, and multiple samplings of ionic ratios were essential for proper interpretation of ischemia-induced myocardial electrolyte derangements.

摘要

在犬冠状动脉结扎后的24小时内,每隔一定时间测定心肌阳离子电解质。在每个时间间隔,计算心脏不同区域的重复电解质比率。为了进行统计分析,将来自两个边缘区域和四个远离梗死区域的比率分别汇总为区域B和区域N的值,并与梗死区域(区域I)的值进行比较。缺血诱导的组织Mg++/Ca++变化在时间进程和区域变化方面与K+/Na+变化平行。在区域I中,K+/Na+和Mg++/Ca++在最初1小时内急剧下降,此后下降变得较为缓慢,在24小时时接近细胞外液水平。组织学上看似正常的区域B的变化遵循类似的下降趋势,但在幅度上与区域I的变化不同(P小于0.01)。区域N的变化较小,但并不总是与假手术犬的值重叠。得出的结论是,组织K+/Na+和Mg++/Ca++降低是心肌缺血的敏感但非特异性指标,对离子比率进行多次采样对于正确解释缺血诱导的心肌电解质紊乱至关重要。

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