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目的 :观察腺苷预处理 (APC)对缺血心肌相关冠状动脉 (冠脉 )微循环功能的保护作用。方法 :将建立心肌缺血模型的 12只中国小型家猪随机分为两组 :对照组 6只 ,仅制备心肌缺血模型 ;APC组 6只 ,制备模型前经冠脉注入腺苷 6mg。应用冠脉内多普勒导丝观察模型相关冠脉平均峰值流速 (APV)、舒张收缩流速比值(DSVR)、冠脉血流储备 (CFR)的变化。结果 :两组模型冠脉狭窄后 10min时APV、DSVR、CFR均较基础状态时明显下降 (P <0 .0 5或 <0 .0 1) ,APV、DSVR在随后实验过程中无明显变化 ;30min时两组CFR均有进一步降低趋势 (P >0 .0 5 ) ;6 0min时对照组CFR较 30min时明显降低〔(0 .96± 0 .2 7)∶(1.74± 0 .4 9) ,P <0 .0 5〕 ,而APC组CFR与 30min时相比差异无统计学意义〔(1.6 4± 0 .30 )∶(1.79± 0 .38) ,P >0 .0 5〕 ;但 12 0min时APC组CFR较前明显下降〔(0 .94± 0 .31)∶(1.6 4± 0 .30 ) ,P <0 .0 1〕 ,与同时间点对照组相比差异无统计学意义。结论 :心肌缺血模型相关冠脉在急性重度狭窄 6 0min时发生微循环功能障碍 ,APC对冠脉微循环功能具有保护作用 ,但持续时间较短。
Objective: To observe the protective effect of adenosine preconditioning (APC) on the microcirculation function of coronary artery (coronary artery) in ischemic myocardium. Methods: Twelve Chinese miniature pigs with myocardial ischemia model were randomly divided into two groups: control group (6 rats), only myocardial ischemia model (APC group) and APC group (6 rats). The changes of coronary artery mean peak velocity (APV), diastolic and systolic velocity ratio (DSVR) and coronary flow reserve (CFR) were observed with coronary Doppler wire. Results: APV, DSVR and CFR decreased significantly (P <0.05 or <0.01) at 10min after coronary artery stenosis in both groups. There was no significant change in APV and DSVR during the subsequent experiment. CFR of both groups decreased further at 30min (P> 0.05); CFR of control group decreased significantly at 60min compared with 30min [(0.96 ± 0.27) :( 1.74 ± 0.49) , P <0.05), while there was no significant difference in CFR between APC group and 30 min group ((1.6 4 ± 0.30) :( 1.79 ± 0.38), P> 0.05) Compared with the former group, the CFR of APC group was significantly decreased at 12 0min ([(0 .94 ± 0.31) vs (1.6 4 ± 0.30), P <0.01], but no significant difference compared with the control group significance. CONCLUSION: Microcirculation dysfunction occurs in the coronary artery associated with myocardial ischemia 60 minutes after acute severe stenosis. APC has a protective effect on coronary microcirculation, but its duration is short.