【摘要】 目的观察依那普利、单纯补液对急性右心室心肌梗死(RVMI)心源性休克时血流动力学指标的作用。方法结扎犬冠状动脉造成大面积RVMI并发心源性休克模型。随机分为对照组、补液组、依那普利组。观察各组正常时、梗死后即刻及给药后即刻、1h、1周时点的平均动脉压(MAP)、心排血量(CO)、右心房压力(RAP)、右心室收缩压(RVSP)等血流动力学指标,并评价疗效。结果快速补液后,RAP进一步升高,加重了血流动力学变化。依那普利治疗后RAP降低,CO增加,血流动力学变化得以改善。结论大面积RVMI心源性休克时,快速扩容治疗在RAP≥13mmHg时会进一步损害左、右心室功能,依那普利可降低右心后负荷,增加CO,能有效纠正休克。更多还原

【Abstract】 Objective To study the therapeutic effects of Enalapril on hemodynamic indexes in cardiac shock dogs induced by acute right ventricular myocardial infarction(RVMI).Methods Models of RVMI accompanied with cardiac shock were induced by ligating coronary artery.Dogs were randomly divided into three groups:control group,fluid replacement group and Enalapril group.The hemodynamie indexes including mean arterial pressure(MAP),cardiac output (CO),right atrial pressure(RAP)and right ventrieular systolic pressure(RVSP)were measured before and immediately after RVMI model establishment,and 1 hour and 1 week after the treatment.The therapeutic effects were evaluated. Results After rapid fluid replacement treatment,RAP became higher and the hemodynamics deteriorated.After Enalapril treatment,RAP decreased and CO increased.Conclusion When RVMI in large area occurs,fluid replacement would further deteriorate the heart function of left and right ventricles when RAP≥13 mmHg,and Enulapril fluid replacement would reduce the right ventricle load and improve shock.更多还原