中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2008年
3期
231-233
,共3页
纵隔%自主神经传导阻滞%高脂血症%冠状动脉硬化%血液动力学现象
縱隔%自主神經傳導阻滯%高脂血癥%冠狀動脈硬化%血液動力學現象
종격%자주신경전도조체%고지혈증%관상동맥경화%혈액동역학현상
Mediastium%Autonomic nerve block%Hyperlipidemia%Coronary arteriosclerosis%Hemodynamic phenomena
目的 探讨纵隔阻滞(MB)对高脂血症兔冠状动脉粥样硬化形成及血液动力学的影响.方法 健康雄性新西兰白兔48只,随机分为4组(n=12),对照组:普通饲料150 g/d喂养16周;高脂组:高脂饲料150 g/d喂养16周;胸段硬膜外阻滞(TEB)组:高脂饲料150 g/d喂养16周,第13至16周行TEB(2%利多卡因2 mg/kg,2次/日);MB组:高脂饲料150 g/d喂养16周,第13至16周MB(2%利多卡因2 mg/kg,2次/日).测定第一次阻滞前后的血液动力学指标,并于实验第1天和实验第4、8、12、16周测定血清总胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平.实验第16周处死全部兔,光镜下评价心肌横断面肌间小动脉粥样硬化程度.结果 阻滞后TEB组MAP明显下降(P＜0.05),而MB组MAP维持稳定.与对照组比较,高脂组、TEB组及MB组血清TC、TG、LDL-C水平升高(P＜0.01或0.05).与高脂组比较,TEB组及MB组心肌肌间小动脉粥样硬化率和内膜增厚率均明显降低(P＜0.01);MB组与TEB组比较差异无统计学意义.结论 纵隔阻滞可抑制高脂血症兔冠状动脉粥样硬化的形成,其抑制程度与胸段硬膜外阻滞相似,而纵隔阻滞对血液动力学无明显影响.
目的 探討縱隔阻滯(MB)對高脂血癥兔冠狀動脈粥樣硬化形成及血液動力學的影響.方法 健康雄性新西蘭白兔48隻,隨機分為4組(n=12),對照組:普通飼料150 g/d餵養16週;高脂組:高脂飼料150 g/d餵養16週;胸段硬膜外阻滯(TEB)組:高脂飼料150 g/d餵養16週,第13至16週行TEB(2%利多卡因2 mg/kg,2次/日);MB組:高脂飼料150 g/d餵養16週,第13至16週MB(2%利多卡因2 mg/kg,2次/日).測定第一次阻滯前後的血液動力學指標,併于實驗第1天和實驗第4、8、12、16週測定血清總膽固醇(TC)、甘油三脂(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)水平.實驗第16週處死全部兔,光鏡下評價心肌橫斷麵肌間小動脈粥樣硬化程度.結果 阻滯後TEB組MAP明顯下降(P＜0.05),而MB組MAP維持穩定.與對照組比較,高脂組、TEB組及MB組血清TC、TG、LDL-C水平升高(P＜0.01或0.05).與高脂組比較,TEB組及MB組心肌肌間小動脈粥樣硬化率和內膜增厚率均明顯降低(P＜0.01);MB組與TEB組比較差異無統計學意義.結論 縱隔阻滯可抑製高脂血癥兔冠狀動脈粥樣硬化的形成,其抑製程度與胸段硬膜外阻滯相似,而縱隔阻滯對血液動力學無明顯影響.
목적 탐토종격조체(MB)대고지혈증토관상동맥죽양경화형성급혈액동역학적영향.방법 건강웅성신서란백토48지,수궤분위4조(n=12),대조조:보통사료150 g/d위양16주;고지조:고지사료150 g/d위양16주;흉단경막외조체(TEB)조:고지사료150 g/d위양16주,제13지16주행TEB(2%리다잡인2 mg/kg,2차/일);MB조:고지사료150 g/d위양16주,제13지16주MB(2%리다잡인2 mg/kg,2차/일).측정제일차조체전후적혈액동역학지표,병우실험제1천화실험제4、8、12、16주측정혈청총담고순(TC)、감유삼지(TG)、고밀도지단백(HDL-C)、저밀도지단백(LDL-C)수평.실험제16주처사전부토,광경하평개심기횡단면기간소동맥죽양경화정도.결과 조체후TEB조MAP명현하강(P＜0.05),이MB조MAP유지은정.여대조조비교,고지조、TEB조급MB조혈청TC、TG、LDL-C수평승고(P＜0.01혹0.05).여고지조비교,TEB조급MB조심기기간소동맥죽양경화솔화내막증후솔균명현강저(P＜0.01);MB조여TEB조비교차이무통계학의의.결론 종격조체가억제고지혈증토관상동맥죽양경화적형성,기억제정도여흉단경막외조체상사,이종격조체대혈액동역학무명현영향.
Objective To investigate the effects of mediastinal block(MB)on coronary atherogenesis and hemodynamics in rabbits with hyperlipoidemia.Methods Forty-eight male New Zealand white rabbits were randomly divided into 4 groups(n=12 each):control group received normal diet 150 g/d for 16 weeks,hypercholesterol group received hypercholesterol diet 150 g/d for 16 weeks,thoracic epidurial block(TEB)group received hypercholesterol diet 150 g/d for 16 weeks and TEB was performed from 13th to 16th week with 2% lidocaine 2 mg/kg twice a day,and MB group received hypercholesterol diet 150 g/d for 16 weeks and MB was performed from 13th to 16th week with 2% lidocaine 2 mg/kg twice a day.MAP was measured before and after 1st block was performed.The serum levels of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)were measured on 1st day,and on4th,6th,8th and 16th week during the experiment.At the end of 16 th week,all rabbits were killed by air embolism.Heart was removed and kept in 10% formalin for a week.The ventricles were transversely sectioned at the level of papillary muscle and slices from the cross section of the ventricles were obtained for determination of the degree of atherosclerosis by microscopy.Results MAP was decreased significandy after TEB in TEB group,while there was no significant changes in MAP after MB in MB group(P＜0.05).The serum levels of TC,TG and LDL-C were significandy higher in hypercholesterol.TEB and MB groups than in control group(P＜0.05 or 0.01).The ratios of atherogenesis and intimal thickening were significantly lower in TEB and MB groups than in hyperoholesterol group(P＜0.01),there was no significant difference between TEB and MB groups.Conclusion Mediastinal block can inhibit the development of coronary atherogenesis in rabbits with hyperlipoidemia to a great degree similar to that of thoracic epidural block,but has no effect on hemodynamics.
