CAJ | 학술논문

目的观察肾动脉舒张功能改变与机械创伤致迟发性心功能不全的关系. 方法 Wistar大鼠28只(意外死亡4只)按随机数字表法分为伪创伤组和创伤组,创伤组又分为创伤后6h和24h组,每组8只；利用Noble-Collip机械创伤仪制备机械创伤模型,通过离体心脏灌流技术检测大鼠左心室内压上升最大速率(+dp/dtmax)、左心室内压下降最大速率(-dp/dtmax)的变化,离体微血管环技术检测肾动脉舒张功能的改变,ELISA检测血清和心肌组织血管紧张素Ⅱ(angiotensin Ⅱ,Ang Ⅱ)水平. 结果与伪创伤组比较,创伤后24 h组大鼠离体心功能明显下降,且创伤后6h组大鼠肾动脉血管环对乙酰胆碱(acetylcholine,Ach)引起的最大内皮依赖性舒张反应显著下降；创伤后6,24 h组血清和心肌组织AngⅡ含量显著升高,呈正相关；心肌组织AngⅡ含量变化与+dp/dtmax呈负相关,与-dp/dtmax呈正相关. 结论机械性创伤可能通过引起肾动脉内皮依赖性舒张功能障碍而导致随后的心功能下降,AngⅡ的过度激活可能在其中发挥着重要作用.
목적 관찰신동맥서장공능개변여궤계창상치지발성심공능불전적관계. 방법 Wistar대서28지(의외사망4지)안수궤수자표법분위위창상조화창상조,창상조우분위창상후6h화24h조,매조8지；이용Noble-Collip궤계창상의제비궤계창상모형,통과리체심장관류기술검측대서좌심실내압상승최대속솔(+dp/dtmax)、좌심실내압하강최대속솔(-dp/dtmax)적변화,리체미혈관배기술검측신동맥서장공능적개변,ELISA검측혈청화심기조직혈관긴장소Ⅱ(angiotensin Ⅱ,Ang Ⅱ)수평. 결과 여위창상조비교,창상후24 h조대서리체심공능명현하강,차창상후6h조대서신동맥혈관배대을선담감(acetylcholine,Ach)인기적최대내피의뢰성서장반응현저하강；창상후6,24 h조혈청화심기조직AngⅡ함량현저승고,정정상관；심기조직AngⅡ함량변화여+dp/dtmax정부상관,여-dp/dtmax정정상관. 결론 궤계성창상가능통과인기신동맥내피의뢰성서장공능장애이도치수후적심공능하강,AngⅡ적과도격활가능재기중발휘착중요작용.
Objective To investigate correlation between change of renal artery diastolic function and subsequent heart failure following mechanical trauma.Methods Twenty-eight Wistar rats,of which four died from accidents,were divided randomly into sham group and trauma group (subgroups at 6 hours and 24 hours after trauma),with 8 rats per group.Models of mechanical trauma in rats were created by Noble-Collip drum.Maximum rate of left ventricular pressure rise (+ dp/dtmax) and fall (-dp/dtmax) in rats were detected through isolated heart perfusion technique.Alteration of renal artery diastolic function was observed by isolated micro-vessel technique.Contents of angiotensin H (Ang Ⅱ)in serum and myocardium tissue were tested by ELISA method.Results In vitro heart function in the group at 24 hours after trauma showed significant decrease and maximum endothelium-dependent diastolic response of renal artery vascular ring to acetylcholine(Ach) in the group at 6 hours after trauma showed obvious decrease,as compared with the sham group.Ang Ⅱ contents in serum and myocardium tissue in the groups at 6 and 24 hours after trauma were significantly higher than those in the sham group and appeared to be positively correlated.Meantime,Ang Ⅱ contents in myocardium tissue were negatively related to + dp/dtmax,but was positively correlated with-dp/dtmax.Conclusions Mechanical trauma may induce subsequent cardiac insufficiency by disturbing renal artery endothelium-dependent diastolic function.Moreover,excessive activation of Ang Ⅱ may play an important role in the entire process.