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目的 研究不同剂量的异丙酚对犬急性心肌缺血再灌注损伤时血流动力学的影响。方法 杂种家犬 18只随机分为NS组 (生理盐水对照组 ,2ml·kg-1·h-1)、HP组 (高剂量异丙酚组 ,11 2mg·kg-1·h-1)和LP组 (低剂量异丙酚组 ,5 6mg·kg-1·h-1) ;开胸阻断左冠脉前降支 (LAD) 90min后再灌注 2 0 0min ,于注药前、注药 6 0min、阻断 90min以及再灌注 6 0min、12 0min和 180min时 ,分别测定和计算心率 (HR) ,体循环指标包括平均动脉压 (MAP)、中心静脉压 (CVP)、体循环阻力 (SVR) ,肺循环指标包括肺动脉压 (PAP)、肺动脉嵌压 (PCWP)和肺循环阻力 (PVR)、心排指数 (CI)。结果 缺血再灌注时HP和LP组的HR变化较小 ;体循环指标中除NS组MAP阻断后比阻断前降低 2 7% (P <0 0 5 ) ,其余变化不明显 ;缺血再灌注对肺循环的影响较大 ,但对NS组影响更大 ;再灌注 12 0min和 180min时HP组和LP组的心功能指标CI基本恢复阻断前水平 ,高于NS组同时间点的CI(P <0 0 5 )。结论 异丙酚对犬急性心肌缺血再灌注损伤时的心率有一定稳定作用 ,对体循环、肺循环和心功能有一定保护作用。
Objective To study the effects of different doses of propofol on hemodynamics in acute myocardial ischemia-reperfusion injury in dogs. Methods 18 hybrid dogs were randomly divided into NS group (saline control group, 2ml · kg-1 · h-1), HP group (high dose propofol group, 112mg · kg-1 · h-1) LP group (low-dose propofol group, 56mg · kg-1 · h-1); thoracotomy blocking left anterior descending coronary artery (LAD) 90min before reperfusion 200min, before injection, injection Heart rate (HR) was measured and calculated at 6 min, 90 min and 60 min, 120 min and 180 min after reperfusion. The indexes of systemic circulation including mean arterial pressure (MAP), central venous pressure (CVP), systemic resistance (SVR) Pulmonary circulation indices included pulmonary arterial pressure (PAP), pulmonary arterial pressure (PCWP), and pulmonary resistance (PVR) and cardiac index (CI). Results The changes of HR in HP and LP groups during ischemia-reperfusion were small. In the systemic circulation index, the MAP in the NS group was decreased by 27% (P <0.05), but the other changes were insignificant. Perfusion had a greater effect on pulmonary circulation, but had a greater effect on NS group. At 12 and 180 min after reperfusion, CI of heart function index in HP group and LP group recovered to the level before blocking, higher than that of NS group P <0 0 5). Conclusion Propofol has a certain stabilizing effect on heart rate during acute myocardial ischemia-reperfusion injury in dogs, and has some protective effects on systemic circulation, pulmonary circulation and cardiac function.