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琥珀酸钠甲泼尼龙在犬冠状动脉闭塞24小时后无法减小梗死面积或维持酶活性。

Inability of methylprednisolone sodium succinate to decrease infarct size or preserve enzyme activity measured 24 hours after coronary occlusion in the dog.

作者信息

Vogel W M, Zannoni V G, Abrams G D, Lucchesi B R

出版信息

Circulation. 1977 Apr;55(4):588-95. doi: 10.1161/01.cir.55.4.588.

Abstract

Methylprednisolone sodium succinate (50 mg/kg) was given 30 minutes before or after the start of a 90 minute occlusion of the left circumflex coronary artery (LCX) in one group of dogs. In a second group, methylprednisolone sodium succinate was given 15 minutes after permanent occlusion of the left anterior descending artery (LAD). Infarct size was determined by dehydrogenase staining after 24 or 96 hours. Heart slices were incubated with nitro-blue tetrazolium and nonstaining infarcted tissue was dissected and weighed. Myocardial depletion of creatine phosphokinase activity (CPK) and lactate dehydrogenase activity (LDH) were determined 24 hours after temporary LCX occlusion. When measured after 24 hours, methylprednisolone sodium succinate treatment did not reduce infarct size or decrease enzyme loss. After temporary LCX occlusion infarct size was 30.4 +/- 3.6% of left ventricular weight in control dogs and 30.0 +/- 2.3% in treated dogs. No significant difference in infarct size was observed in hearts examined 24 or 96 hours after myocardial infarction. After permanent LAD occlusion, infarct size in control dogs was 39.2 +/- 1.6% of left ventricular weight and 33.7 +/- 3.5% in treated dogs. CPK activity in the LCX area decreased by 26.5 +/- 7% in controls and by 28.1% +/- 7% in treated dogs. Treated dogs sustained a significantly greater fall in arterial blood pressure after LCX occlusion than did controls. During LCX occlusion and upon reperfusion, methylprednisolone sodium succinate treated dogs exhibited a significantly greater number of premature ventricular beats. Since infarct size and enzyme depletion were not reduced when measured after 24 hours, methylprednisolone sodium succinate treatment does not appear to have enhanced myocardial cell viability.

摘要

在一组犬中,于左旋冠状动脉(LCX)90分钟闭塞开始前或开始后30分钟给予琥珀酸钠甲泼尼龙(50毫克/千克)。在第二组中,于左前降支动脉(LAD)永久性闭塞后15分钟给予琥珀酸钠甲泼尼龙。在24小时或96小时后通过脱氢酶染色确定梗死面积。将心脏切片与硝基蓝四氮唑一起孵育,解剖并称重未染色的梗死组织。在临时闭塞LCX 24小时后测定肌酸磷酸激酶活性(CPK)和乳酸脱氢酶活性(LDH)的心肌消耗情况。在24小时后测量时,琥珀酸钠甲泼尼龙治疗并未减小梗死面积或减少酶的损失。在临时闭塞LCX后,对照犬的梗死面积为左心室重量的30.4±3.6%,治疗犬为30.0±2.3%。在心肌梗死后24小时或96小时检查的心脏中,未观察到梗死面积有显著差异。在LAD永久性闭塞后,对照犬的梗死面积为左心室重量的39.2±1.6%,治疗犬为33.7±3.5%。LCX区域的CPK活性在对照组中下降了26.5±7%,在治疗犬中下降了28.1%±7%。与对照组相比,治疗犬在LCX闭塞后动脉血压下降幅度明显更大。在LCX闭塞期间及再灌注时,琥珀酸钠甲泼尼龙治疗的犬出现室性早搏的次数明显更多。由于在24小时后测量时梗死面积和酶消耗并未减少,琥珀酸钠甲泼尼龙治疗似乎并未增强心肌细胞活力。

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