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目的 探讨多巴酚丁胺负荷超声心动图 (DSE)中 β受体阻滞剂对心肌缺血的抑制作用 ,比较胰高血糖素和阿托品在逆转 β受体阻滞剂效应及增强心肌缺血检测能力中的作用。 方法 实验动物猪 11只 ,结扎其左前降支造成冠脉狭窄模型。在此模型上行基础多巴酚丁胺负荷试验 (DST) ,静滴Esmolol 5 0 μg/(kg·min)后重复DST ,并在DST达到峰剂量时静脉推注胰高血糖素或阿托品各 1.0mg分别与多巴酚丁胺进行联合负荷试验(DGST和DAST)。观察三个实验阶段心肌灌流、代谢、收缩功能及血流动力学变化。结果 β受体阻滞剂明显抑制DST过程中的心肌缺血反应 ,DGST几乎完全、DAST部分逆转 β受体阻滞剂对心肌灌流、代谢、收缩和血流动力学的影响。结论 DGST逆转 β受体阻滞剂对心肌缺血的抑制作用优于DAST ,作为一种新的联合药物试验方法可增加DSE检测心肌缺血的敏感性
Objective To investigate the inhibitory effect of β blockers on myocardial ischemia in dobutamine stress echocardiography (DSE). To compare the effects of glucagon and atropine on reversing the effect of β - blockers and enhancing myocardial ischemia Detection of the role of capacity. Methods Eleven experimental pigs were ligated with their left anterior descending coronary artery to form coronary artery stenosis model. In this model, basal dobutamine stress test (DST) was repeated after Dose Esterol 50 μg / (kg · min) and intravenous injection of glucagon or atropine 1.0 at the peak dose of DST mg were combined with dobutamine stress test (DGST and DAST). Three experimental stages of myocardial perfusion, metabolism, systolic function and hemodynamic changes were observed. Results β-blockers significantly inhibited myocardial ischemia response during DST, and DGST was almost complete. DAST partially reversed the effects of β-blockers on myocardial perfusion, metabolism, contractility and hemodynamics. Conclusions DGST reversal β-blocker is more effective than DAST in inhibiting myocardial ischemia, as a new combination drug test method can increase the sensitivity of DSE in detecting myocardial ischemia