无血管活性药物支持下静脉快速推注胺碘酮对急性心肌梗死兔模型血流动力学的影响

目的观察无血管活性药物支持下单独静脉快速推注胺碘酮对急性心肌梗死后兔模型血流动力学的影响。方法健康新西兰大白兔24只，随机分为4组，每组各6只。SG组：假手术后予静推5％葡萄糖液；SA组：假手术后予5mg／kg胺碘酮静脉快速推注：AG组：发生急性心肌梗死后静推5％葡萄糖液；AA组：发生急性心肌梗死后予5mg／kg胺碘酮静脉快速推注。记录推注药液后30min各组的心率（HR）、平均动脉压（MAP）、左心室收缩压（LVSP）、左心室舒张末压（LVEDP）、左心室内压最大上升速率（＋dp／dtmax）、左心室内压最大下降速率（-dp／dtmax）。结果与SG组比较，SA组兔子在推注胺碘酮后即刻出现MAP下降、伴随LVSP、HR、-dp，dtmax、＋dp/dtmax下降，LVEDP升高，以推注后即刻至2min最为显著，差异均有统计学意义（P＜0．05）；AA组在2min时与AG组比较，MAP快速下降（36±4）％，HR减慢（14±1）％，LVSP下降（37±5）％，＋dp／dtmax下降（49±4）％，-dp／dtmax下降（31±4）％，LVEDP升高（22±4）％，差异均有统计学意义（P＜0．05）；AA组MAP（2～10min）、＋dp／dtmax（4～30min）、LVEDP（6～20min）与SA组比较，差异均有统计学意义（P＜0．05）。结论无血管活性药物支持下，单独静脉快速推注胺碘酮后即刻出现显著的心血管负性抑制，以心肌收缩功能抑制为主；这种心肌收缩功能抑制在急性心肌梗死情况下更为显著。

Hemodynamic influence of Amiodarone by bolus vein injection without vasoactive agent on rabbits model with acute myocardial infarction

Objective To observe the influence of Amiodarone by bolus vein injection without vasoactive agent on rabbits model with acute myocardial infarction. Methods 24 New Zealand rabbits were divided into four groups, with 6 rabbits in each group. SG group： after sham-operation, given 5% glucose by vein injection; SA group： after sham-operation, given 5 mg/kg Amiodarone by bolus vein injection; AG group： after acute myocardial infarction （AMI） happened, given 5% glucose vein injection; AA group： after AMI happend, given 5 mg/kg amiodarone by bolus vein injection. The heart rate （HR）, mean arterial pressure （MAP）, left ventricular systolic pressure（LVSP）, ventrieular end diastolic pressure （LVEDP）, left ventrieular interior maximum pressure rise rate （＋dp/dt max） and left ventricular interior minimum pressure descend rate （-dp/dtmax） after the drug infusion were recorded. Results Compared with SG group, MAP of SA group showed descend immediately after given amiodarone, with LVSP, HR, -dp/dtmax, ＋dp/dtmax inducing, LVEDP rising, and between given Amiodarone instantly to 2 min they were the most significant, the differences were statistically significant （P 〈0.05）. AA group were compared with AG group at 2 min, MAP induced immediately （36±4）%, HR slowerd （14±1）%, LVSP induced （37±5）%, ＋dp/dtmax induced （49±4）%, -dp/dtmax induced （31±4）%, LVEDP rose （22±4）%, the differences were statistically significant （P 〈0.05）; MAP （2-10 rain）, ＋dp/dtmax（4-30 min）, LVEDP （6-20 min） of AA group were compared with those of SA group, the differences were statistically significant （P 〈0.05）. Conclusion Without vasoaetive agent Amiodarone by bolus vein injection may induce cardiovascular depression mainly characterized by immediate reductions in cardiac contractility, it showes significantly in condition of AMI.