胰岛素治疗对糖尿病心肌力学性能及对乙醇的肌力反应的影响。

R A Brown, A Adams, A O Savage
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摘要

糖尿病会显著影响心脏功能,乙醇也是如此。为了评估胰岛素治疗是否改变急性乙醇暴露的肌力反应和逆转糖尿病诱导的心肌功能障碍,雄性Wistar大鼠静脉注射链脲佐菌素55 mg/kg使其患上糖尿病。在等长条件下,用分离的左心室乳头肌制剂与Tyrode溶液混合,研究了乙醇对正常、糖尿病和胰岛素治疗(8周)糖尿病动物的肌力作用。在没有和存在临床相关浓度乙醇的情况下,测定10分钟内出现的峰值张力、到达峰值张力的时间(TPT)、到达松弛90%的时间(RT90)、最大张力出现率(+VT)和最大张力下降率(-VT)。在胰岛素治疗的糖尿病肌肉中,基线发展张力、+VT和-VT增强,TPT和RT90的延长(糖尿病心肌的特征)减弱。乙醇浓度为80 mg/dL时,未治疗的糖尿病心肌的张力降低幅度略大。较高浓度的乙醇(120 ~ 240 mg/dL)降低了各组的张力,且幅度相似。较高乙醇浓度的负性肌力效应与TPT和RT90缩短以及+VT和-VT降低有关。结论:胰岛素治疗后,糖尿病心肌的力学性能恢复正常;然而,胰岛素治疗既不能改变心肌对乙醇的敏感性,也不能改变乙醇负性肌力效应的总体程度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of insulin treatment on the mechanical properties and inotropic response to ethanol in diabetic myocardium.

Diabetes significantly affects cardiac performance, as does ethanol. To assess whether insulin treatment alters the inotropic response to acute ethanol exposure and reverses diabetes-induced myocardial dysfunction, male Wistar rats were made diabetic using streptozocin, 55 mg/kg intravenously. The inotropic effect of ethanol on normal, diabetic, and insulin-treated (8 weeks) diabetic animals was studied using isolated, left-ventricular papillary muscle preparations superfused with Tyrode's solution under isometric conditions. Peak tension developed, time to peak tension (TPT), time to 90% relaxation (RT90), maximum rate of tension developed (+VT), and maximum rate of fall in tension (-VT) were determined in the absence and presence of clinically relevant concentrations of ethanol for 10 minutes. In insulin-treated diabetic muscles, baseline developed tension, +VT, and -VT were enhanced, and the prolongation of TPT and RT90, characteristic of diabetic myocardium, was attenuated. The magnitude of the reduction in developed tension in response to ethanol, 80 mg/dL, was slightly greater in untreated diabetic myocardium. Higher concentrations of ethanol (120 to 240 mg/dL) decreased tension in all groups and was of similar magnitude. The negative inotropic effect of higher ethanol concentrations was associated with shortening of TPT and RT90, as well as a diminution of +VT and -VT. It is concluded that with insulin treatment, the mechanical properties of diabetic myocardium are normalized; however, neither the myocardium's sensitivity to ethanol nor the overall magnitude of ethanol's negative inotropic effect is modified by insulin treatment.

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