Katircioğlu S F, Ulus A T, Işcan Z, Yamak B, Saritaş Z, Birincioğlu L
Türkiye Yüksek Ihtisas Hospital, Cardiovascular Surgery Clinic, Ankara, Turkey.
Prostaglandins Leukot Essent Fatty Acids. 1998 Sep;59(3):169-74. doi: 10.1016/s0952-3278(98)90058-8.
A total of 12 healthy mongrel dogs were subjected to the study. The left anterior descending artery was occluded. The occlusion was done for 15 min. At the end of this period, without removing the occlusion, the heart was retroperfused for 3 h. Then, occlusion was removed and reperfusion was supplied. Animals were divided into two equal groups. Six animals received iloprost and the other six control did not receive any additional treatment. In the iloprost group, the drug was administered into the coronary sinus. After 15 min following occlusion, iloprost was infused at a rate of 50 microg/min continuously. Cardiac output (CO), mean arterial pressure (MAP), mean pulmonary arterial pressure (MPAP), heart rate (HR), pulmonary capillary wedge pressure (PCWP), right atrium pressure (RAP), myocardial oxygen extraction (MOE) and myocardial lactate extraction (MLE) parameters were examined in the two groups, before and during retroperfusion and during the reperfusion (1-4 h). Iloprost retroperfusion (50 microg/min) was started at the fifteenth minute of occlusion and continued till the end of the observation period (3 h). The measured hemodynamic data showed that the hearts treated with iloprost had satisfactory preservation of cardiac function. At the end of the reperfusion period cardiac output was 1.5 +/- 0.06 L/min in the control and 1.7 +/- 0.04 L/min in the iloprost group (P < 0.05). At the end of the reperfusion period, tumor necrosis factor level was raised significantly in the control group (P < 0.05). Myocardial lactate release was also high in the control group (P < 0.05). CPK-MB release was low in the iloprost group (P < 0.05). We conclude that retrogradely administered iloprost reduced the risk of myocardial injury and it is probable that this drug effectively distributes to the area of myocardium at risk.
共有12只健康的杂种狗参与了这项研究。左前降支动脉被阻塞。阻塞持续15分钟。在此时间段结束时，在不解除阻塞的情况下，对心脏进行逆行灌注3小时。然后，解除阻塞并进行再灌注。动物被分为两组，每组6只。6只动物接受伊洛前列素治疗，另外6只作为对照组不接受任何额外治疗。在伊洛前列素组中，药物通过冠状窦给药。阻塞15分钟后，以50微克/分钟的速率持续输注伊洛前列素。在两组中，分别在逆行灌注前、逆行灌注期间以及再灌注期间（1 - 4小时）检测心输出量（CO）、平均动脉压（MAP）、平均肺动脉压（MPAP）、心率（HR）、肺毛细血管楔压（PCWP）、右心房压（RAP）、心肌氧摄取（MOE）和心肌乳酸摄取（MLE）参数。伊洛前列素逆行灌注（50微克/分钟）在阻塞的第15分钟开始，并持续至观察期结束（3小时）。测量的血流动力学数据表明，接受伊洛前列素治疗的心脏心脏功能得到了良好的保存。再灌注期结束时，对照组的心输出量为1.5±0.06升/分钟，伊洛前列素组为1.7±0.04升/分钟（P < 0.05）。再灌注期结束时，对照组肿瘤坏死因子水平显著升高（P < 0.05）。对照组心肌乳酸释放也较高（P < 0.05）。伊洛前列素组肌酸磷酸激酶同工酶（CPK - MB）释放较低（P < 0.05）。我们得出结论，逆行给药的伊洛前列素降低了心肌损伤的风险，并且这种药物可能有效地分布到有风险的心肌区域。
