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[坎利酸钾(安体舒通注射剂)对实验性心肌梗死血流动力学及心肌缺血的影响]

[Influence of canrenoate potassium (aldactone pro injections) on hemodynamics and myocardial ischemia in experimental myocardial infarct].

作者信息

Kötter V, Leitner E v, Arbeiter G, Cordes R, Schröder R

出版信息

Z Kardiol. 1975 Jul;64(7):672-86.

PMID:1163092
Abstract

The effects of the positive-inotropic drug Canrenoat-Kalium (CRK) on the extent and severity of myocardial ischemic injury and on hemodynamic parameters were studied in 17 dogs following coronary occlusion. Acute myocardial infarction causes depression of left-ventricular function. There eas a significant decrease in dp/dtmax, stroke volume and cardiac output; average values for mean arterial pressure were reduced, but not significantly. There was a significant increase in left-ventricular enddiastolic pressure. Heart rate was unchanged. In the healing phase of myocardial infarction a significant elevation of left-ventricular enddiastolic pressure and a significant decrease of arterial pressure persisted, but the other parameters had returned toward normal. Intravenous administration of CRK (20 mg/kg) one hour after coronary occlusion causes a significant increase in left-ventricular dp/dtmax, cardiac output and stroke volume, but no significant change in arterial pressure, heart rate and left-ventricular enddiastolic pressure. Four days after myocardial infarction administration of CRK causes also a significant incrrease in left-ventricular dp/dtmax and -n 4 out of 5 animals an increase in stroke volume. Heart rate, arterial pressure and left-ventricular enddiastolic pressure are unchanged. There is a continuous deterioration of all hemodynamic parameters in the control group 1 hour and 96 hours after experimental myocardial infarction. This spontaneous deterioration has to be taken into consideration estimating the effect of CRK in experimental conditions. 120 epicardial electrocardiographic recordings were used to assess the extent and severity of myocardial ischemic injury. The average ST-segment elevation and the number of sites with abnormal ST-segments were significantly reduced 20 min after CRK administration. The study suggests a beneficial therapeutic role for CRK treatment of left-ventricular failure in the acute and healing phase after myocardial infarction.

摘要

在17只犬冠状动脉闭塞后,研究了正性肌力药物Canrenoat-Kalium(CRK)对心肌缺血性损伤的范围和严重程度以及血流动力学参数的影响。急性心肌梗死会导致左心室功能降低。dp/dtmax、每搏量和心输出量显著下降;平均动脉压平均值降低,但不显著。左心室舒张末期压力显著升高。心率未改变。在心肌梗死愈合期,左心室舒张末期压力显著升高和动脉压显著降低持续存在,但其他参数已恢复正常。冠状动脉闭塞1小时后静脉注射CRK(20mg/kg)可使左心室dp/dtmax、心输出量和每搏量显著增加,但动脉压、心率和左心室舒张末期压力无显著变化。心肌梗死后4天给予CRK也可使左心室dp/dtmax显著增加,并且在5只动物中有4只每搏量增加。心率、动脉压和左心室舒张末期压力未改变。在实验性心肌梗死后1小时和96小时,对照组所有血流动力学参数持续恶化。在评估CRK在实验条件下的作用时,必须考虑这种自发恶化。使用120份心外膜心电图记录来评估心肌缺血性损伤的范围和严重程度。给予CRK后20分钟,平均ST段抬高和ST段异常部位的数量显著减少。该研究表明CRK在心肌梗死后急性和愈合期治疗左心室衰竭方面具有有益的治疗作用。

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