我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

GIK对缺血/再灌注犬心肌超微结构的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2011年第6期
页码:
727-730
栏目:
基础研究
出版日期:
2011-12-25

文章信息/Info

Title:
Effects of high-dose glucose-insulin-potassium (GIK) on ultramicrostructure in a canine model of myocardial ischemia and reperfusion
作者:
何 蓉1; 姚德厚1; 董 玲2; 高 峰2; 王春梅3; 李 源4
1.成都军区机关医院心内科，四川 成都 610083；第四军医大学：2.生理学教研室， 3.电镜教研室，4.西京医院老年病科，陕西 西安 710032
Author(s):
HE Rong1;  Yao De-hou1;  DONG Ling2;  GAO Feng2;  WANG Chun-mei3;  Li Yuan4
1.Department of Cardiovascular Medicine, Chengdu Military Institution Hospital, Chengdu 610083, Sichuan, China; 2.Department of Physiology, 3.Department of Teaching and Research Section of Electron Microscope, 4.Department of Gerontology, Xijing Hospital, Fourth Military Medical University, Xi’an 710032, Shanxi, China
关键词:
心肌缺血; 葡萄糖-胰岛素-钾液; 缺血/再灌注损伤; 心肌超微结构; 犬
Keywords:
myocardial infarction;  glucose-insulin-potassium;  ischemia/reperfusion injury;  ultramicrostructure
分类号:
R542.2
DOI:
-
文献标识码:
A
摘要:
目的:观察葡萄糖-胰岛素-钾液（GIK）、葡萄糖-钾液（GK）对急性心肌缺血/再灌注（MI/R）犬心肌缺血区内心肌细胞改变的影响，分析GIK中的胰岛素对MI/R心肌细胞的保护作用。 方法: 将犬心肌定量缺血(左前降支血流量降低80%) 50 min,再灌注4 h，建立犬MI/R模型。24只杂种犬随机分为GIK组、GK组和盐水对照组(n=8)，于再灌注前5 min，分别输注GIK、GK和生理盐水。再灌注4 h后，计算梗死区占缺血区重量的百分比，并制作电镜切片于透射电镜下观察。 结果: GIK可显著减少心肌梗死(MI)的范围［GIK组（5.2±0.8）% vs. 盐水对照组（9.4±0.8）%，P<0.05］；而GK组MI的范围（8.5±0.9）%则与盐水对照组无明显差异。与盐水对照组相比，GIK组对非缺血心肌的超微结构无影响，对缺血心肌有一定的保护作用。GK对缺血心肌无保护作用。结论: 再灌注时，静脉输注GIK可减轻心肌超微结构的损伤，其中的胰岛素是GIK上述作用的关键成分。
Abstract:
AIM:To study the effect of glucose-insulin-potassium (GIK) on changes of dog myocardial cells after ischemia-reperfusion injury following acute myocardial ischemia/reperfusion (MI/R) and to explore the role of insulin in the protective effects of GIK on myocardium. METHODS: In anesthetized open-chest dogs, the left anterior descending coronary artery (LAD) was partially occluded (80% reduction in its blood flow) for 50 min and reperfused for 4 h. Dogs were randomly divided into three groups: GIK, GK and saline. All treatments began at 5 min before reperfusion ［infused at 2 ml/(kg·h), i.v.］ and continued during the 4-h reperfusion. The ratio of necrosis area was determined. Myocardial infarction was determined by the ultrastructure of ischemic myocardium at the end of the reperfusion. RESULTS: The ratio of myocardial necrosis showed attenuation in GIK group ［(5.2±0.8)% vs. saline (9.4±0.8)%, P<0.05］, but no reduction was observed in myocardial infarct size in the GK group ［(8.5±0.9)% vs. saline (9.4±0.8)%］. Compared with saline, GK had no significant effects on the ultrastructure of ischemic myocardium, whereas GIK had significant effects on the ultrastructure of ischemic myocardium. CONCLUSION: GIK exerts some protective effects on myocardium by alleviating ultrastructural injury of myocardium. Insulin may play a leading role in the actions of GIK.

参考文献/References

[1]Apstein CS,Taegtmeyer H.Glucose-insulin-potassium in acute myocardial infarction:the time has come for a large, prospective trial[J].Circulation,1997,96(4):1074-1077.

[2]Fath-Ordoubadi F,Beatt KJ.Glucose-insulin-potassium therapy for treatment of acute myocardial infarction:an overview of randomized placebo-controlled trials[J].Circulation,1997,96(4):1152-1156.

[3]张绪洪,邵建华,张兴华,等.极化液对冠心病患者纤溶活性的影响[J].中华心血管病杂志,1999,27(4):264-264.

[4]张 航向,臧益民,黄 路,等.极化液给予时机对缺血/再灌注犬心脏功能及心肌损伤的影响[J].心脏杂志,2005,17(5):419-423.

[5]钱学贤.极化液、胰岛素保护缺血/再灌注的新机制——又一个老药新观点的典范[J].中华内科杂志,2003,42(3):145-147.

[6]Apstein CS.Glucose-insulin-potassium for acute myocardial infarction: remarkable results from a new prospective, randomized trial[J].Circulation,1998,98(21):2223-2226.

[7]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(12):1497-1502.

[8]Rymarz E,Mosiewicz J,Hanzlik J.The influence of polarizing GIK mixture on the indicat ors ofmyocardial necr osis[J].Ann Univ Mariae Curie Sklodowska,2003,58(1):5-10.

[9]马兰香,贾国良,张 清,等.高、低剂量极化液对缺血/再灌注心肌保护作用的对比研究[J].第四军医大学学报,2003, 24(22):2087-2090.

[10]高 峰,施东伟,王晓明,等.极化液对缺血/再灌大鼠心肌细胞死亡及心脏功能的影响: 胰岛素的关键作用[J].中华内科杂志,2003,42(3):148-152.

[11]张 博,高 峰,张海锋,等.胰岛素促进模拟缺血/再灌注心肌细胞收缩功能恢复:Akt的关键作用[J].科学通报, 2003, 48(10):1045-1049.

[12]何 蓉,李 源,霍建华,等.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[J].心脏杂志,2005,17(3):229-234.

[13]马 恒,霍建华,张航向,等.胰岛素对急性心肌缺血再灌注犬心脏及冠状动脉功能的影响[J].中华医学杂志,2006,86(44):3128-3132.

备注/Memo

备注/Memo:
收稿日期：2009-01-19.基金项目：基金项目:国家自然科学基金项目资助（30471923,30370525） 通讯作者:李源，教授，主要从事老年心脏疾病的临床研究Email:ggcgxl@fmmu.edu.cn 作者简介:何蓉，主治医师，硕士Email:zhw.uest@qq.com
更新日期/Last Update: 2011-12-27