急性心肌缺血时低切变率下全血粘度变化机理研究

本实验旨在分析狗急性心肌缺血时低切变率下全血粘度异常升高与红细胞电泳率(EM)和血浆纤维蛋白原浓度变化间的关系。实验结果表明,阻断冠脉血流40min时,低切变率下全血粘度已显著升高,EM明显降低,二者呈高度负相关,此时血浆纤维蛋白原浓度仅轻度增加。缺血时间进一步延长时,EM逐渐恢复,而血浆纤维蛋白原浓度显著升高,此时低切变率下全血粘度升高主要与血浆纤维蛋白原变化有关。     

急性心肌缺血对血液流变学和心脏收缩功能改变的影响

在麻醉开胸狗观察了急性心肌缺血对血液流变学和心脏收缩功能改变的影响。在阻断狗前降支冠脉1h内,血液流变学各参数发生异常变化,表现为高、低切变率下全血粘度(ηbh、ηb1)、血浆粘度、血细胞压积和纤维蛋白原升高,红细胞电泳时间缩短。同步描记心电、心音和颈动脉搏动图而记录的心脏收缩时间间期,表现为射血前期(PEP)延长、左室射血时间(LVET)缩短和PEP/LVET比值增大。此外,动脉舒张压(DAP)升高,心输出量(CO)减少。上述各参数均与对照值有明显差异,P<0.05。缺血40min时,对ηb1和PEP/LVET或DAP进行相关分析,呈明显正相关,P<0.05;ηb1和CO呈明显负相关,P<0.01。结果提示,心肌缺血后发生的血液流变学异常变化,具有增加射血阻力和减少心输出量的作用。     

狗急性心肌缺血早期冠脉侧支血流量与血液流变学变化的关系

本实验在14只麻醉开胸狗身上观察了急性心肌缺血早期冠脉侧支血流量与血液流变学变化的关系。动物均分为两组:Ⅰ组,在不控制血压的情况下,观察心肌缺血早期单位压力差下冠脉侧支血管流量(CVC)的变化;Ⅱ组,在保持主动脉血压不变的条件下,根据 Wyatt 等公式计算流经缺血区末梢血管的有效侧支血流量(ECF)。实验结果表明,阻断冠脉血流30min时,低切变率下全血比粘度已明显增高,随后继续增加,60min 时Ⅰ、Ⅱ两组分别较对照值增高19.0%和11.4%(均为P<0.01)。血液粘度增高时,CVC 仅轻度降低(p>0.05),但 ECF却随着血液粘度的增高而逐渐明显降低,缺血60min 时较对照值降低12.1±2.6%(P<0.01)。血液粘度变化与 ECF 变化之间呈明显负相关(r=-0.796,p<002)。上述结果提示,心肌缺血早期血液流变学的异常变化虽然对冠脉侧支血管的血流阻力影响较小,但却使流经缺血区末梢血管的有效侧支血流量明显减少而加重心肌缺血。     

急性低氧性缺氧小鼠血液粘度与红细胞流变性变化

目的:观察小鼠急性低氧性缺氧(AHH)后红细胞流变性与血液粘度的变化。方法:32只健康昆明小鼠均分为:对照组、AHH组(复制模型,分为5 min、8 min、11 min三个亚组),在相应时间点,快速颈部脱臼后,从心尖取血,检测各组小鼠血液粘度与红细胞流变性指标。结果:与对照组相比,低氧5 min组各切变率下的全血粘度、全血相对粘度、全血还原粘度均显著降低,红细胞变形指数显著升高;低氧8 min组和低氧11 min组的群体细胞电泳时间显著延长、细胞电泳长度与细胞迁移率显著降低;低氧8 min组的全血相对粘度、全血还原粘度、红细胞聚集指数均显著高于、红细胞变形指数显著低于低氧5 min组。结论:AHH可引起小鼠血液粘度降低、红细胞电泳能力下降。     

肾上腺髓质在急性心肌缺血时血液流变学变化中的作用

本实验观察了阻断冠脉血流后血液流变学的变化并分析了肾上腺髓质活动增强在急性心肌缺血早期血液流变学变化中的作用。实验结果表明,对照组阻断冠脉血流40min时全血粘度已显著增加,血细胞压积、血浆纤维蛋白原浓度逐渐升高。阻断冠脉血流前切断双侧内脏大神经可消除心肌缺血早期血液流变学的异常变化,而切断内脏大神经后输注肾上腺素又可使心肌缺血时全血粘度、血细胞压积等各项指标出现明显异常。上述结果提示,阻断冠脉血流后交感-肾上腺系统活动增强可能是急性心肌缺血早期血液流变学变化的重要原因。     

大鼠肝癌诱发过程中血粘度及红细胞变形能力的异常改变

为了全面地反映肝癌发生发展整个过程的血液流变性的异常,本实验采用二乙基亚硝胺诱发大鼠肝癌模型,分六个相检测五个切变率下的全血粘度、血浆粘度及红细胞变形能力。结果表明红细胞变形能力随着肿瘤发展逐渐减低,血浆粘度随着诱癌时间延长 渐升高,到肿瘤晚期趋于平缓,而全血粘度先是升高,到诱癌２０周以后反而有下降趋势。     

大功率微波急性辐照对血液流变特性的影响

用２．４５ＧＨｚ的连续微波对大白兔在体血液和人离体血液进行急性大剂量辐照,对辐照前和辐照后的血液粘度,粘弹性,血小板聚集性,红细胞脆性进行了实验研究,实验结果表明：微波辐照后兔血的粘度和粘弹性值降低,人血的粘度在低切变率下降低,在较高的切变率下升高;兔血小板聚集功能降低,二相聚集的解聚率增大;红细胞的脆性增大。     

大功率微波急性辐照对血液流变特性的影响

用２．４５ＧＨｚ的连续微波对大白兔在体血液和人离体血液进行急性大剂量辐照,对辐照前和辐照后的血液粘度,粘弹性,血小板聚集性,红细胞脆性进行了实验研究,实验结果表明：微波辐照后兔血的粘度和粘弹性值降低,人血的粘度在低切变率下降低,在较高的切变率下升高;兔血小板聚集功能降低,二相聚集的解聚率增大;红细胞的脆性增大。     

肝郁脾虚证模型大鼠血流变及TXB2、PGF1a的变化

目的:探查中医肝郁脾虚证模型的血流变及相关调节因子的状态。方法:采用慢性束缚应激 过度疲劳 饮食失节法建立大鼠肝郁脾虚证模型,测定大鼠造模三周、自然恢复一周时的血流变和血浆TXB2、PGF1a。结果:与正常组相比,模型组大鼠造模三周150/s、38/s、10/s、5/s切变率下的全血粘度和还原粘度均显著升高(P＜0．001),红细胞聚集指数显著降低(P＜0．001),红细胞压积显著升高(P＜0．01),红细胞变形指数无显著性差异(P＞0．05);血浆TXB2显著升高(P＜0．001),6-keto-PGF1a显著降低(P＜0．05), TXB2/PGF1a显著升高(P＜0．01);模型组大鼠第四周150/s、38/s、10/s、5/s切变率下的全血粘度和还原粘度仍显著升高(P＜0．001或P＜0．01);红细胞聚集指数显著降低(P＜0．001);红细胞压积与变形指数无显著性差异(P＞0．05);血浆TXB2和TXB2/PGF1a显著降低(P＜0．05),6-keto-PGF1a显著升高(P＜0．05)。结论:肝郁脾虚证大鼠存在血液高粘和血栓易形成状态,恢复期血液高粘同时伴有扩血管因素的加强。提示肝郁脾虚证有血流变的异常和血浆TXA2-PGI2的平衡失调,主要涉及到血小板和血浆因素的参与。     

丹参酮ⅡA磺酸钠对冠心病心绞痛及血液流变学疗效观察

目的:观察丹参酮ⅡA磺酸钠对冠心病心肌缺血的有效性及血液流变学的影响。方法:将50例冠心病患者随机分为治疗组(26例)与对照组(24例)。对照组常规应用硝酸异山梨酯与阿司匹林等。前者在常规治疗基础上加用丹参酮ⅡA碘酸纳注射液60mg(1次/天)。每例于治疗开始前与结束后,进行血液流变学与心电图(ECG)检测。结果:两组心肌缺血症状治疗前后均有改善。与对照组相比,治疗组的效果更为显著(P均＜0．05)。治疗组血液流变学指标:低切变率下全血黏度、高切变率下全血黏度、纤维蛋白原(Fbg)、血浆D-二聚体(DD)均显著下降(P＜0．05)。其改善血液流变学指标的疗效优于对照组(P＜0．05)。结论:丹参酮ⅡA磺酸钠可改善血液流变性作用,是治疗冠心病心肌缺血的一种有效的药物。     

Intermittent peripheral tissue ischemia during coronary ischemia reduces myocardial infarction through a KATP-dependent mechanism: first demonstration of remote ischemic perconditioning

Remote ischemic preconditioning reduces myocardial infarction (MI) in animal models. We tested the hypothesis that the systemic protection thus induced is effective when ischemic preconditioning is administered during ischemia (PerC) and before reperfusion and examined the role of the K(+)-dependent ATP (K(ATP)) channel. Twenty 20-kg pigs were randomized (10 in each group) to 40 min of left anterior descending coronary artery occlusion with 120 min of reperfusion. PerC consisted of four 5-min cycles of lower limb ischemia by tourniquet during left anterior descending coronary artery occlusion. Left ventricular (LV) function was assessed by a conductance catheter and extent of infarction by tetrazolium staining. The extent of MI was significantly reduced by PerC (60.4 +/- 14.3 vs. 38.3 +/- 15.4%, P = 0.004) and associated with improved functional indexes. The increase in the time constant of diastolic relaxation was significantly attenuated by PerC compared with control in ischemia and reperfusion (P = 0.01 and 0.04, respectively). At 120 min of reperfusion, preload-recruitable stroke work declined 38 +/- 6% and 3 +/- 5% in control and PerC, respectively (P = 0.001). The force-frequency relation was significantly depressed at 120 min of reperfusion in both groups, but optimal heart rate was significantly lower in the control group (P = 0.04). There were fewer malignant arrhythmias with PerC during reperfusion (P = 0.02). These protective effects of PerC were abolished by glibenclamide. Intermittent limb ischemia during myocardial ischemia reduces MI, preserves global systolic and diastolic function, and protects against arrhythmia during the reperfusion phase through a K(ATP) channel-dependent mechanism. Understanding this process may have important therapeutic implications for a range of ischemia-reperfusion syndromes.     

犬心肌缺血早期血小板聚集功能和冠脉侧支循环的改变

本实验在18只麻醉开胸犬观察了急性心肌缺血早期血小板聚集功能和冠脉侧支循环功能的变化。实验结果如下:阻断冠脉后心肌缺血区血液中血小板聚集率(PAgR)增大,血小板计数(PC)减少。缺血50min时,PAgR增大58.7±5.6％,PC减少39.5±23.6％,与对照值有明显差异(均为P<0.01)。与此同时,在控制血压条件下,心肌缺血早期单位压力差下冠脉侧支血流量的变化与对照值无明显差异,而根据Wyatt等公式计算的流经缺血区末梢血管的有效侧支血流量明显降低,缺血50min时较对照值降低23.5±9.7％(P<0.05)。PAgR变化与有效侧支血流量改变呈明显负相关(r=-0.887,P<0.01);冠脉侧支指数与梗塞范围呈明显负相关(r=-0.847,P<0.01)。阻断冠脉前静脉注射血小板聚集功能抑制剂阿斯匹林,可明显减轻上述各项参数的异常变化。这些结果提示,心肌缺血早期血小板聚集功能的异常变化虽然对冠脉侧支血管的血流阻力影响较小,但却使流经缺血区末梢血管的有效侧支血流量明显减小,进而扩大梗塞范围。     

Ischemia stimulates the release of atrial natriuretic peptide from rat cardiac ventricular myocardium in vitro.

The effect of ischemia on atrial natriuretic peptide (ANP) release from heart ventricles was studied by exposing the perfused hearts of Wistar-Kyoto (WKY) and spontaneously hypertensive (SHR) rats to global ischemia after excision of the atria. Ischemia for 2, 5 and 20 min caused an increase of 0.3 +/- 1.1, 12.4 +/- 5.5 and 11.4 +/- 4.2 ng/g dry weight in ANP release of the WKY ventricles, respectively. ANP release increased 3.4 +/- 2.8 ng/g dry weight after 5 minutes' ischemia from the SHR ventricles. The increase was not caused by cell damage, as only processed form of the peptide was detected in the perfusates. The increase in ANP release in the WKY ventricles correlated positively with the tissue lactate/pyruvate ratio (r = 0.85) and adenosine (r = 0.99), and negatively with the phosphorylation potential (r = -0.70). The results indicate that ventricular ischemia increases ANP release, probably due to changes in myocardial energy metabolism.     

Alteration of blood hemorheologic properties during cerebral ischemia and reperfusion in rats

The cerebral ischemia and reperfusion rat model was employed in this experiment to study the rheological properties (i.e. viscosity, hematocrit, red blood cell deformability and thixotropic properties) of whole blood. The results of this study show that a significant relation exists between the duration of cerebral ischemia and reperfusion and the viscosity, hematocrit and thixotropic parameters of whole blood, but there is no significant influence on the deformability of RBC. Blood viscosity values declined gradually throughout the ischemia period, e.g., after 1h of ischemia, the values of whole blood viscosity under high, middle and low shear rates were 44, 28 and 23% lower than normal, respectively. Whereas after 1h of reperfusion, the values of viscosity increased rapidly to values 160, 57 and 41% higher than normal under the high, middle and low levels of shear rate, while the viscosity values after 12h of reperfusion tended to return to normal values. The values of hematocrit H and thixotropic parameter tau(0) and mu also gradually declined with the increase in the duration of ischemia, but increased significantly after 1h of reperfusion. The values of H, tau(0) and mu after 1h of reperfusion are significantly greater than that in the period of cerebral ischemia, the value of H, tau(0) is also higher than normal. With the increase in reperfusion time, H, tau(0) gradually returned to normal level, at the same time, mu also decreased.     

Protection against ventricular arrhythmias and cardiac death using adenosine and lidocaine during regional ischemia in the in vivo rat

Despite decades of research, there are few effective ways to treat ventricular fibrillation (VF), ventricular tachycardia (VT), or cardiac ischemia that show a significant survival benefit. Our aim was to investigate the combined therapeutic effect of two common antiarrhythmic compounds, adenosine and lidocaine (AL), on mortality, arrhythmia frequency and duration, and infarct size in the rat model of regional ischemia. Sprague-Dawley rats (n = 49) were anesthetized with pentobarbital sodium (60 mg.ml(-1).kg(-1) i.p.) and instrumented for regional coronary occlusion (30 min) and reperfusion (120 min). Heart rate, blood pressure, and a lead II electrocardiogram were recorded. Intravenous pretreatment began 5 min before ischemia and extended throughout ischemia, terminating at the start of reperfusion. After 120 min, hearts were removed for infarct size measurement. Mortality occurred in 58% of saline controls (n = 12), 50% of adenosine only (305 microg.kg(-1).min(-1), n = 8), 0% in lidocaine only (608 microg.kg(-1).min(-1), n = 8), and 0% in AL at any dose (152, 305, or 407 microg.kg(-1).min(-1) adenosine plus 608 microg.kg(-1).min(-1) lidocaine, n = 7, 8, and 6). VT occurred in 100% of saline controls (18 +/- 9 episodes), 50% of adenosine-only (11 +/- 7 episodes), 83% of lidocaine-only (23 +/- 11 episodes), 60% of low-dose AL (2 +/- 1 episodes, P < 0.05), 57% of mid-dose AL (2 +/- 1 episodes, P < 0.05), and 67% of high-dose AL rats (6 +/- 3 episodes). VF occurred in 75% of saline controls (4 +/- 3 episodes), 100% of adenosine-only-treated rats (3 +/- 2 episodes), and 33% lidocaine-only-treated rats (2 +/- 1 episodes) of the rats tested. There was no deaths and no VF in the low- and mid-dose AL-treated rats during ischemia, and only one high-dose AL-treated rat experienced VF (25.5 sec). Infarct size was lower in all AL-treated rats but only reached significance with the mid-dose treatment (saline controls 61 +/- 5% vs. 38 +/- 6%, P < 0.05). We conclude that a constant infusion of a solution containing AL virtually abolished severe arrhythmias and prevented cardiac death in an in vivo rat model of acute myocardial ischemia and reperfusion. AL combinational therapy may provide a primary prevention therapeutic window in ischemic and nonischemic regions of the heart.     

Mechanosensitivity of mouse tracheal ciliary beat frequency: roles for Ca2+, purinergic signaling, tonicity, and viscosity

Mechanosensitivity is hypothesized to participate in the regulation of ciliary beat frequency (CBF) in airway epithelia. To investigate this hypothesis, CBF in excised mouse trachea was monitored (microscopy image analysis) while varying mucosal shear (perfusate velocity and/or viscosity; planar flow). CBF increased within minutes of step increase to steady shear stress as small as 10(-3) Pa and decreased within minutes of shear reduction (相似文献   

Effects of low-calcium reperfusion and adenosine on diastolic behavior during the transitory systolic overshoot of the stunned myocardium in the rabbit

The aims of the present study were to determine whether the transitory systolic overshoot (TSO) that occurs in the early reperfusion (R) of the stunned myocardium is accompanied by diastolic alterations, and to determine whether the R with low Ca2+ Krebs-Henseleit's solution or with adenosine modifies these alterations. Isolated-isovolumic rabbit hearts were divided in 3 groups (G). G1 (n = 11) was perfused with Krebs-Henseleit's solution, subjected to 15 min of global ischemia and 30 min R; G2 (n = 10) was reperfused during the first 10 min with Krebs-Henseleit's solution [Ca2+] = 1 mmol/L, which was increased in the perfusate to 1.5 mmol/L up to 20 min R and at 2.5 mmol/L from 20 to 30 min R. G3 (n = 12) was perfused with Krebs-Henseleit's solution with adenosine (0.03 microg x kg(-1) x min(-1)) from 10 min before ischemia and during all R. Left ventricular (LV) +dP/dtmax (mmHg/s), LV end diastolic pressure (LVEDP, mmHg), and 1 relaxation index (t(1/2)) were measured in preischemic state, at 30, 50, 60, 70, 90, and 120 s R, and then at 5 and 30 min R. The +dP/dtmax recovered to 621 +/- 77 mmHg/s (p > 0.05), 346 +/- 31 mmHg/s (p < 0.05 vs. G1), and 533 +/- 76 mmHg/s (p > 0.05) from preischemic value of 730 +/- 39, 690 +/- 32, and 758 +/- 57 in G1, G2, and G3, respectively. The LVEDP in G1 and G3 increased early in the R, and it was negatively correlated with the +dP/dtmax (r = -0.63, p = 0.0369; and r = -0.71, p = 0.0090, respectively). The R with low Ca2+ abolished this correlation and attenuated the TSO phase. The correlation between LVEDP and +dP/dtmax in G1 and G3 and the lack of correlation in G2 suggests there are common mechanisms for the systolic and diastolic alterations during the TSO phase that are possibly related to Ca2+ overload but not with the vascular tone.     

Influence of graded dehydration on hyperthermia and cardiovascular drift during exercise.

This investigation determined the effect of different rates of dehydration, induced by ingesting different volumes of fluid during prolonged exercise, on hyperthermia, heart rate (HR), and stroke volume (SV). On four different occasions, eight endurance-trained cyclists [age 23 +/- 3 (SD) yr, body wt 71.9 +/- 11.6 kg, maximal O2 consumption 4.72 +/- 0.33 l/min] cycled at a power output equal to 62-67% maximal O2 consumption for 2 h in a warm environment (33 degrees C dry bulb, 50% relative humidity, wind speed 2.5 m/s). During exercise, they randomly received no fluid (NF) or ingested a small (SF), moderate (MF), or large (LF) volume of fluid that replaced 20 +/- 1, 48 +/- 1, and 81 +/- 2%, respectively, of the fluid lost in sweat during exercise. The protocol resulted in graded magnitudes of dehydration as body weight declined 4.2 +/- 0.1, 3.4 +/- 0.1, 2.3 +/- 0.1, and 1.1 +/- 0.1%, respectively, during NF, SF, MF, and LF. After 2 h of exercise, esophageal temperature (Tes), HR, and SV were significantly different among the four trials (P < 0.05), with the exception of NF and SF. The magnitude of dehydration accrued after 2 h of exercise in the four trials was linearly related with the increase in Tes (r = 0.98, P < 0.02), the increase in HR (r = 0.99, P < 0.01), and the decline in SV (r = 0.99, P < 0.01). LF attenuated hyperthermia, apparently because of higher skin blood flow, inasmuch as forearm blood flow was 20-22% higher than during SF and NF at 105 min (P < 0.05). There were no differences in sweat rate among the four trials. In each subject, the increase in Tes from 20 to 120 min of exercise was highly correlated to the increase in serum osmolality (r = 0.81-0.98, P < 0.02-0.19) and the increase in serum sodium concentration (r = 0.87-0.99, P < 0.01-0.13) from 5 to 120 min of exercise. In summary, the magnitude of increase in core temperature and HR and the decline in SV are graded in proportion to the amount of dehydration accrued during exercise.     

Role of endogenous opioids in ischemic preconditioning but not in short-term hibernation in pigs

Endogenous opioids are involved in ischemic preconditioning (IP) in several species. Whether or not opioids are important for IP and short-term myocardial hibernation (STMH) in pigs is currently unknown. In 34 enflurane-anesthetized pigs, the left anterior descending coronary artery was flow constantly perfused. Subendocardial blood flow (Endo), infarct size (IS; percent area at risk), and the free energy change of ATP hydrolysis (DeltaG) were determined. After 90-min severe ischemia and 120-min reperfusion, IS averaged 28.3 +/- 5.4% (means +/- SE) (n = 8; Endo: 0.047 +/- 0.009 ml. min(-1) x g(-1)). IP by 10-min ischemia and 15-min reperfusion reduced IS to 9.9 +/- 3.8% (P < 0.05, n = 8; Endo: 0.044 +/- 0.009 ml. min(-1) x g(-1)). After naloxone (1 mg/kg iv followed by 2 microg x kg(-1) x min(-1)), IS averaged 25.8 +/- 7.0% (n = 6; Endo: 0.039 +/- 0.008 ml x min(-1) x g(-1)) without and 24.7 +/- 4.7% (n = 6; Endo: 0.044 +/- 0.006 ml x min(-1) x g(-1)) with IP. At 5-min moderate ischemia in the presence of naloxone, Endo decreased from 0.90 +/- 0.07 to 0.28 +/- 0.03 ml x min(-1) x g(-1)and DeltaG decreased from -58.6 +/- 1.0 to -52.6 +/- 0.4 kJ/mol. Prolongation of ischemia to 90 min did not alter Endo, but DeltaG recovered toward control values (57.7 +/- 1.1 kJ/mol), and the myocardium remained viable. These responses are identical to those of nonnaloxone-treated pigs. Endogenous opioids are involved in IP but not in STMH in pigs.