CAJ | 학술논문

目的了解依那普利拉对严重烫伤大鼠早期心肌力学的影响.方法将84只SD大鼠背部造成30%TBSA的Ⅲ度烫伤后,随机分为烫伤组,伤后按Parkland公式腹腔注射等渗盐水;小剂量治疗组、中剂量治疗组、大剂量治疗组,伤后即刻分别腹腔注射1、2、4 mg/kg依那普利拉.烫伤组、小剂量治疗组伤后1、3、6、12、24 h,中剂量治疗组、大剂量治疗组伤后6、12 h左心室置管检测大鼠左心室收缩压(LVSP)、左心室舒张末期压(LVEDP)、左心室压力最大上升/下降速率(±dp/dt max),并处死大鼠取心肌组织检测血管紧张素Ⅱ(AⅡ)含量.另取6只大鼠作为假伤组,模拟烫伤后检测以上指标.结果伤后3～24 h,烫伤组及各剂量治疗组大鼠LVSP、LVEDP、±dp/dt max值普遍低于假伤组(P＜0.05或P＜0.01);而各剂量治疗组LVSP、LVEDP、±dp/dt max值普遍高于烫伤组(P＜0.05或P＜0.01);伤后6、12 h,大剂量治疗组±dp/dt max明显低于小、中剂量治疗组.伤后1 h,烫伤组心肌组织AⅡ含量[(53.0±2.6)pg/200 mg]明显高于假伤组[(14.8±0.7)pg/200 mg,P＜0.01],6 h达高峰,以后逐渐下降,伤后24 h仍明显高于假伤组(P＜0.01);伤后3～24 h.小剂量治疗组AⅡ含量均明显高于假伤组(P＜0.05或P＜0.01),但均低于烫伤组.伤后6 h烫伤组AⅡ含量为(145.2±14.5)pg/200 mg,高于小、中、大剂量治疗组[(65.1±0.9)、(53.6±1.1)、(34.2±0.9)pg/200 mg,P ＜0.01].结论严重烫伤后早期心肌组织损害明显.心功能即明显下降,依那普利托注射液可以改善心肌力学指标、保护心功能,以小剂量效果最为明显.
목적 료해의나보리랍대엄중탕상대서조기심기역학적영향.방법 장84지SD대서배부조성30%TBSA적Ⅲ도탕상후,수궤분위탕상조,상후안Parkland공식복강주사등삼염수;소제량치료조、중제량치료조、대제량치료조,상후즉각분별복강주사1、2、4 mg/kg의나보리랍.탕상조、소제량치료조상후1、3、6、12、24 h,중제량치료조、대제량치료조상후6、12 h좌심실치관검측대서좌심실수축압(LVSP)、좌심실서장말기압(LVEDP)、좌심실압력최대상승/하강속솔(±dp/dt max),병처사대서취심기조직검측혈관긴장소Ⅱ(AⅡ)함량.령취6지대서작위가상조,모의탕상후검측이상지표.결과 상후3～24 h,탕상조급각제량치료조대서LVSP、LVEDP、±dp/dt max치보편저우가상조(P＜0.05혹P＜0.01);이각제량치료조LVSP、LVEDP、±dp/dt max치보편고우탕상조(P＜0.05혹P＜0.01);상후6、12 h,대제량치료조±dp/dt max명현저우소、중제량치료조.상후1 h,탕상조심기조직AⅡ함량[(53.0±2.6)pg/200 mg]명현고우가상조[(14.8±0.7)pg/200 mg,P＜0.01],6 h체고봉,이후축점하강,상후24 h잉명현고우가상조(P＜0.01);상후3～24 h.소제량치료조AⅡ함량균명현고우가상조(P＜0.05혹P＜0.01),단균저우탕상조.상후6 h탕상조AⅡ함량위(145.2±14.5)pg/200 mg,고우소、중、대제량치료조[(65.1±0.9)、(53.6±1.1)、(34.2±0.9)pg/200 mg,P ＜0.01].결론 엄중탕상후조기심기조직손해명현.심공능즉명현하강,의나보리탁주사액가이개선심기역학지표、보호심공능,이소제량효과최위명현.
Objective To investigate the therapeutic effects of Enalaprilat on the myocardial kinetics in rats at early stage of severe scald. Methods Eighty-four SD rats were inflicted with 30% TBSA full-thickness scald,and randomly divided into scald(S,with intraperitoneal injection of isotonic saline according to Parkland formula,n=30),L(n=30),M(n=12)and H(n=12)groups.The rats in L,M,H groups were inIraperitoneally injected with 1,2,4 mg/kg Enalaprilat.Other 6 healthy rats were enrolled into study as control(C group).The myocardial kinetic parameters including left ventricular systolic pressure(LVSP),left ventricular end diastolic pressure(LVEDP),±dp/dt max and the levels of A Ⅱ in myoeardium were ob-served at 1,3,6,12 and 24 post scald hour(PBH)in L and S groups,and at 6,12 PBH in M and H groups.The above indices in C group were also examined. Results The Ievels of LVSP,LVEDP,±dp/dt max in C group were higher than those in other groups during 3～24 PBH(P＜0.05 or P＜0.01),while those in L,M,H groups were obviously higher than those in S group(P＜0.05 or P＜0.01).The level of±dp/dt max in H group at 6.12 PBH were obviously lower than those in L and M groups.The level of A Ⅱ in S group at 1 PBH was(53.0±2.6)pg/200 mg,which was significantly higher than thatin C group[(14.8±0.7)pg/200 mg,P＜0.05 or P＜0.01];it peaked at 6 PBH and lowered afterwards,and they were signif-icantly higher than that in C group at 24 PBH(P＜0.01).The levels of AⅡ in L group during 3～24 PBH were obviously higher than those in C group(P＜0.01),which were also lower than those in S group.The level of AⅡin S group was significantly higher than in L,M,H groups at 6 PBH[(145.2±14.5)pg/200 mg.vs.(65.1±0.9)pg/200 mg,(53.6±1.1)ps/200mg,(34.2±0.9)pg/200 mg,respectively,P＜0.01]. Conclusion Myocardium can be obviously damaged at early stage after severe scald.cardiac function is impaired.Enalaprilat injection(especially at low dose)can significantly ameliorate the myocardial kinetics indices,and it seems to exert a protective effect on cardiac function.