【摘要】 目的探讨高渗盐水对心力衰竭犬心脏结构功能、血流动力学及肾脏血流量的作用。方法用快速心室起搏法建立心衰犬模型,分为假手术组、对照组、盐水组、速尿组、盐水+速尿组,分别在起搏前、起搏6周、盐水治疗2周后观测下列指标:超声心动检查,测量左室舒张末径(LVEDD),左室收缩末径(LVESD),左室射血分数(LVEF)、心排出量(CO)、肾脏血流量(RBF);漂浮导管测量右房压(RAP)、平均肺动脉压(MPAP)、肺毛细血管楔嵌压(PCWP)、平均动脉压(MAP)、左室舒张末压(LVEDP)。结果单纯模型组与假手术组比较,血流动力学变化明显,RAP、PCWP、LVEDP升高,MAP降低,超声观测LVESD、LVEDD增大,LVEF、CO、RBF显著下降(P<0.05或P<0.01);高渗盐水+速尿组,LVEF、CO、RBF、MAP明显增加,LVEDD、RAP、LVEDP、PCWP降低明显;高渗盐水组RBF较对照组有显著差异(P<0.05或P<0.01);速尿组各指标与对照组比较均无变化。结论高渗盐水配合速尿能够增加心衰犬肾脏血流量,改善其降低的肾灌注,并改善部分心脏结构和功能指标和血流动力学状况。更多还原

【Abstract】 AIM To observe the effects of hypertonic saline solution on the structure and function of cardiol,hemodynamics and renal blood flow in canine congestive heart failure induced by chronic rapid ventricular pacing.METHODS Thirty-one canines were divided randomly into sham operated group(n=6),model group(n=6),hypertonic saline solution(HSS) group(n=6),furosemide group(n=6),HSS and furosemide(n=7) and ventricle pacing group administered by HSS and furosemide(n=7).The canines in the controls and the HSS groups were paced for 6 weeks.Before and after 6 weeks,2 weeks after administration of HSS and furosemide,echocardiography and hemodynamic parameters were measured include RAP,LVEDP,PCWP,MAP,CO,RBF,LVEF,LVESD,LVEDD.RESULTS Significant changes were found in all the above echocardiography and hemodynamic parameters between the sham operated group and the model group.(P<0.05 or P<0.01).Compared with those in the model group,furosemide-group and HSS group,the parameters of LVEF,CO,RQ and MAP in HSS and furosemide group increased significantly(P<0.05) and LVEDD,RAP,LVEDP and PCWP significantly diminished(P<0.05).Compared with those in the model group,the parameters of RBF increased significantly after administration of HSS (P<0.05) None of the parameters in furosemide-group was found changed significantly.CONCLUSION HSS plus furosemide can increase the decreased renal blood flow in canine congestive heart failure and improve kidney perfusion and some echocardiography and hemodynamic parameters.更多还原