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在冠状动脉闭塞之前及期间给予牛聚合血红蛋白可减小兔子的梗死面积。

Administration of bovine polymerized haemoglobin before and during coronary occlusion reduces infarct size in rabbits.

作者信息

Rempf C, Standl T, Schenke K, Chammas K, Gottschalk A, Burmeister M-A, Gottschalk A

机构信息

Department of Anaesthesiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Germany.

出版信息

Br J Anaesth. 2009 Oct;103(4):496-504. doi: 10.1093/bja/aep233. Epub 2009 Aug 26.

Abstract

BACKGROUND

Haemoglobin-based oxygen carriers (HBOC) seem to increase the risk of mortality and myocardial infarction in clinical trials. Therefore, we designed this randomized placebo-controlled animal study to evaluate the effects of prophylactic and therapeutic administration of HBOC in a myocardial ischaemia-reperfusion model with respect to infarct size and areas of impaired perfusion (no reflow, NR).

METHODS

Thirty-two anaesthetized, mechanically ventilated rabbits were randomized to one of the four groups. Group G1 received 0.4 g kg(-1) i.v. HBOC-200 25 min before coronary artery occlusion, G2 received the same dose i.v. 10 min after occlusion, and G3 and 4 received i.v. saline. G1, 2, and 3 were subjected to 30 min occlusion of left coronary artery followed by 240 min of reperfusion. G4 was treated without ischaemia-reperfusion. Measurement included assessment of the area at risk and infarct size using triphenyltetrazolium chloride stain and areas of NR using thioflavin stain. Ischaemia-reperfusion was confirmed by microspheres technique.

RESULTS

Infarct size as a percentage of the area at risk was significantly reduced in G1 [25 (sd 13)%, P=0.026] and G2 [22 (20)%, P=0.009] compared with G3 [48 (17)%]. The areas of NR in percentage of the area at risk [G1, 26 (15)%; G2, 34 (22)%; G3, 36 (12)%; G4, 5 (3)%] did not differ between the groups of animals undergoing coronary occlusion and reperfusion.

CONCLUSIONS

Prophylactic and therapeutic administration of HBOC-200 reduces infarct size in myocardial ischaemia and reperfusion in rabbits. This reduction of infarct size is not accompanied by an improvement of areas of NR.

摘要

背景

在临床试验中,基于血红蛋白的氧载体(HBOC)似乎会增加死亡风险和心肌梗死风险。因此,我们设计了这项随机安慰剂对照动物研究,以评估在心肌缺血再灌注模型中预防性和治疗性给予HBOC对梗死面积和灌注受损区域(无复流,NR)的影响。

方法

32只麻醉、机械通气的兔子被随机分为四组。G1组在冠状动脉闭塞前25分钟静脉注射0.4 g kg(-1) HBOC-200,G2组在闭塞后10分钟静脉注射相同剂量,G3组和G4组静脉注射生理盐水。G1、2和3组进行左冠状动脉闭塞30分钟,随后再灌注240分钟。G4组未进行缺血再灌注处理。测量包括使用氯化三苯基四氮唑染色评估危险区域和梗死面积,以及使用硫黄素染色评估NR区域。通过微球技术确认缺血再灌注情况。

结果

与G3组[48(17)%]相比,G1组[25(标准差13)%,P = 0.026]和G2组[22(20)%,P = 0.009]的梗死面积占危险区域的百分比显著降低。在接受冠状动脉闭塞和再灌注的动物组中,NR区域占危险区域的百分比[G1组,26(15)%;G2组,34(22)%;G3组,36(12)%;G4组,5(3)%]在各组之间无差异。

结论

预防性和治疗性给予HBOC-200可减少兔子心肌缺血再灌注时的梗死面积。梗死面积的减少并未伴随着NR区域的改善。

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