麻醉犬冠状动脉结扎过程中异丙酚对心血管的影响。

Y J Cheng, S Z Fan, T L Chen, Y P Wang, P P Tan
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摘要

在正常心脏和冠状动脉结扎心脏不同输注速率下,用12只杂种狗冠状动脉结扎模型测量异丙酚对血流动力学的影响。异丙酚在正常心脏和结扎后分别静脉滴注10mg /kg,然后以20mg /kg/hr、40mg /kg/hr和80mg /kg/hr连续输注30min。我们研究的血药浓度范围为2.19 +/- 0.56微克/毫升至15.78 +/- 3.31微克/毫升。结扎于左前降支第一斜支下1cm处,数秒内可见明显的心血管改变。然而,结扎前和结扎后30分钟的血流动力学变化不明显。随着异丙酚血药浓度的升高,非结扎组和结扎组的平均动脉压(MAP)、心输出量(CO)和心率(HR)呈极显著负相关(p < 0.01),而中心静脉压(CVP)和肺动脉闭塞压(PAOP)随异丙酚血药浓度的升高均无显著降低。在我们的研究中,输注高达80mg /kg/hr的异丙酚并没有进一步降低冠状动脉结扎心脏的MAP、CO和全身血管阻力(SVR)。即使血药浓度高达15微克/毫升,各组间SVR和肺血管阻力(PVR)变化也不显著。我们得出结论,尽管SVR和PVR稳定,但异丙酚抑制心肌功能与血液异丙酚浓度升高有关。异丙酚对正常心脏和冠脉结扎心脏的血流动力学影响相似。(摘要删节250字)
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardiovascular effects of propofol during coronary ligation in anesthetized dogs.

Under different infusion rates in normal hearts and hearts with coronary ligation, the hemodynamic effects of propofol were measured in a coronary artery ligation model in twelve mongrel dogs. Propofol was given by 10 mg/kg intravenous bolus followed by 30 min infusion in succession with 20 mg/kg/hr, 40 mg/kg/hr and 80 mg/kg/hr in both normal hearts and hearts with coronary ligation. The range of blood concentrations in our study is 2.19 +/- 0.56 microgram/ml to 15.78 +/- 3.31 micrograms/ml. After ligation at 1 cm below first diagonal branch of left anterior descending artery (LAD) obvious cardiovascular changes were seen in a few seconds. However, non-significant hemodynamic changes were demonstrated between pre-ligated and 30 min after ligation. With increasing blood propofol concentrations, there was significant negative correlation (p < 0.01) in mean arterial pressure (MAP), cardiac output (CO) and heart rate (HR) but central venous pressure (CVP) and pulmonary arterial occlusion pressure (PAOP) decreased non-significantly with increasing propofol concentrations in both non-ligated and ligated groups. Propofol infusion up to 80 mg/kg/hr did not decrease MAP, CO and systemic vascular resistance (SVR) further in hearts with coronary ligation than normal hearts in our study. SVR and pulmonary vascular resistance (PVR) changed non-significantly between each groups even in blood concentration as high as 15 micrograms/ml. We conclude that propofol depresses myocardial function associated with increasing blood propofol concentrations despite stable SVR and PVR. The hemodynamic effects of propofol were similar in the normal hearts and hearts with coronary ligation.(ABSTRACT TRUNCATED AT 250 WORDS)

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