Wynsen J C, Preuss K C, Gross G J, Brooks H L, Warltier D C
Department of Pharmacology, Medical College of Wisconsin, Milwaukee 53226.
Am Heart J. 1988 Oct;116(4):915-25. doi: 10.1016/0002-8703(88)90141-x.
The effects of methylprednisolone sodium succinate (20 mg/kg, intravenously administered) on the time course of functional recovery of myocardium following a 15-minute coronary artery occlusion period and subsequent 5 hour reperfusion period were studied in chronically instrumented, conscious dogs. In comparison to a control group, animals receiving methylprednisolone 90 minutes prior to coronary occlusion demonstrated less depression of regional segment shortening following 15 minutes of reperfusion (52 +/- 13% vs control levels of 23 +/- 7% of preocclusion values) and improved recovery at 5 hours postreperfusion (106 +/- 6% vs control levels of 54 +/- 4% of preocclusion values). In animals receiving methylprednisolone immediately prior to reperfusion, there was also similar recovery of segment shortening at 5 hours (97 +/- 3%). In contrast, dogs receiving methylprednisolone 15 minutes after the onset of reperfusion or sodium succinate (5.5 mg/kg, intravenously administered) 90 minutes prior to occlusion demonstrated no improvement in recovery of function. Experiments in dogs not subjected to coronary occlusion documented that methylprednisolone sodium succinate lacked inotropic and vasodilator properties. The results suggest that methylprednisolone administered prior to or during coronary artery occlusion but not after reperfusion enhances the functional recovery of hypokinetic, postischemic, reperfused myocardium. These effects are unrelated to any direct hemodynamic action of steroids or to the sodium succinate salt.
在长期植入仪器的清醒犬中，研究了琥珀酸甲泼尼龙（20mg/kg，静脉注射）对冠状动脉闭塞15分钟及随后5小时再灌注后心肌功能恢复时间进程的影响。与对照组相比，在冠状动脉闭塞前90分钟接受甲泼尼龙的动物在再灌注15分钟后局部节段缩短的抑制作用较小（52±13%，而对照组为闭塞前值的23±7%），且在再灌注后5小时恢复情况改善（106±6%，而对照组为闭塞前值的54±4%）。在再灌注前立即接受甲泼尼龙的动物中，5小时时节段缩短也有类似的恢复（97±3%）。相比之下，在再灌注开始后15分钟接受甲泼尼龙的犬或在闭塞前90分钟接受琥珀酸钠（5.5mg/kg，静脉注射）的犬，功能恢复未得到改善。未进行冠状动脉闭塞的犬的实验表明，琥珀酸甲泼尼龙缺乏变力性和血管舒张特性。结果表明，在冠状动脉闭塞前或闭塞期间而非再灌注后给予甲泼尼龙可增强运动减弱、缺血后再灌注心肌的功能恢复。这些作用与类固醇的任何直接血流动力学作用或琥珀酸钠盐无关。
