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葡萄糖胰岛素钾液对心肌缺血/再灌注犬血液流变学和血糖的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2005年第3期
页码:
229-231,234
栏目:
基础研究
出版日期:
2005-05-05

文章信息/Info

Title:
The effects of high dose GIK on hemorheological characteristics and blood glucose in a canine model of myocardial ischemia and reperfusion
作者:
何蓉1李源1霍建华2马恒2张健保3高峰2
第四军医大学:1.西京医院老年病科,2.生理学教研室,陕西 西安710032;3.西安交通大学生物医学工程研究所,陕西 西安 710048
Author(s):
HE Rong1LI Yuan1HUO Jianhua2MA Heng2ZHANG Jianbao3GAO Feng2
1.Department of Gerontology,Xijing Hospital,Fourth Military Medical University,Xi′an, Shaanxi,710032,China
关键词:
血液流变学缺血/再灌注极化液血糖
Keywords:
hemorheologyischemia/reperfusionglucoseinsulinpotassiumblood glucosedogs
分类号:
R542.2
DOI:
-
文献标识码:
A
摘要:
目的 观察近年推荐使用的大剂量葡萄糖胰岛素钾液(GIK)对急性心肌缺血/再灌注(MI/R) 犬血液流变学特性的影响。方法 定量狭窄冠状动脉左前降支(血流量降低80%)制作犬心肌缺血/再灌注模型。 将24只杂种犬随机分为GIK组、葡萄糖钾液(GK)组及生理盐水对照组(n=8)。再灌注同时分别静脉输注GIK、GK、生理盐水(2 ml·h-1·kg-1)。在狭窄冠脉前和再灌注即刻及再灌注后1 h、2 h、4 h抽取冠状静脉窦血,测定血液流变学和血糖变化。结果 缺血50 min时各组犬血细胞比容、全血高切粘度、全血低切粘度较缺血前均有不同程度增高(P<0.05)。GIK组再灌注后各时间点血糖和血液流变学指标与缺血前及生理盐水对照组相比均无显著差异。GK组再灌注后2 h 和4 h时血细胞比容(HCT)较生理盐水对照组增高(P<0.05)。再灌注后GIK组与生理盐水组血糖无明显升高,GK组再灌注后2 h 和4 h血糖较对照组分别增加76%和92%(P<0.01)。结论 急性心肌缺血可致血液流变学特性显著改变,主要表现为HCT、ηbh、ηbl 增高。本研究所用GIK的剂量不会导致血糖明显变化,且对MI/R过程中犬血液流变学无明显影响;本研究结果还提示,单独输注高糖可能对急性心肌缺血患者不利。
Abstract:
AIM To investigate and compare the effects of glucoseinsulinpotassium (GIK) and glucosepotassium (GK) on hemorheological characteristics in myocardial ischemia/reperfusion (MI/R) dogs. METHODS Twenty four dogs were subjected to 50 min myocardial ischemia followed by 4 h reperfusion, and randomly received one of the following treatments: saline (0.9% NaCl), GIK (glucose: 50 g/L, insulin: 60 U/L, potassium: 80 mmol/L) and GK iv infusion at the rate of 2 ml·h-1·kg-1,(n=8). The hemorheological indices and blood glucose were measured before , after ischemia and following reperfusion. RESULTS Acute ischamia resulted in the elevations of hemorheological blood viscosity at both high and low shear rates(P<0.05)。 Compared with saline control, the high does GIK used in the present study did not significantly change blood glucose and the hemorheological properties in the MI/R dogs.While GK increased blood glucose and hematocrit ( HCT) at 2 h and 4 h after reperfusion. CONCLUSION Acute myocardial ischemia indexes significant hemorheological changes characterized by the elevations of HCT and blood viscosity.The highdose of GIK used in this study has no significant effects on blood glucose and hemoreological characteristics of MI/R dogs.The data of this study also indicate that administration of amount of glucose may be deleterious for MI/R.

参考文献/References

[1]范家骏,赵国欣,刘泽富. 血液流变学基础与临床[M]. 西安:陕西科学技术出版社,1995.

[2]马新亮,臧益民,朱妙章,等. 肾上腺髓质在急性心肌缺血时血液流变学变化中的作用[J]. 生理学报, 1988,40(2):30-34.

[3]高峰,施东伟,王晓明,等. 极化液对缺血/再灌大鼠心肌细胞功能的影响:胰岛素的关键作用[J]. 中华内科杂志,2003,42(3):148-151.

[4]马兰香,高晖,赵新国,等. 高、低剂量极化液对缺血/再灌心肌细胞凋亡及相关基因的影响[J]. 心脏杂志,2004,16(5):429-430.

[5]Gao F, Gao E, Yue TL, et al. Nitric oxide mediates the antiapoptotic effect of insulin in myocardial ischemia/reperfusion: the roles of PI3-kinase, Akt, and endothelial nitric oxide synthase phosphorylation[J]. Circulation, 2002, 105: 1497-1502.

[6]Das UN. Uses of glucoseinsulinpotassium regimen[J]. Med Sci Monit, 2000,6(6): 1053-1055.

备注/Memo

备注/Memo:
收稿日期:2004-11-30.
更新日期/Last Update: 2010-01-05