星状神经节阻滞对心肌缺血再灌注损伤的影响

目的：探讨左侧星状神经节阻滞对心肌缺血再灌注损伤的预防作用及其机制，以建立一种新的围术期心肌保护方法。方法：选用健康新西兰白兔32只，随机分为4组，A组为对照组，其他3组为缺血再灌注组，其中B组采用左侧星状神经节阻滞。常规建立在体心肌缺血再灌注损伤模型。分别于开胸后10min，阻断左前降支（LAD）前，再灌注5、30、90min测心率（HR）、左室峰压（LVP）、左室内压最大上升速率（ dp/dtmax），并经冠状静脉窦口抽血测神经肽Y(NPY）和去甲肾上腺素（NE）。结果：左侧星状神经节阻滞组，在心肌缺血再灌注5、30、90min时间点，冠状静脉血血浆NPY和NE水平均明显降低；在再灌注90min时，血流动力学指标LVP、 dp/dtmax值明显上升。结论：左侧星状神经节阻滞对心肌缺血再灌注损伤有一定预防作用。

Effect of stellate ganglion block on myocardial ischemia/reperfusion injury

Objective To investigate the preventive e ffect of left lateral stellate ganglion block on myocardial ischemial/reperfusio n injuny and the mechanism,so as to set up a novel method of perioperative myoc ardial protection.Methods Thirty two rabbits were divided randomly into 4 groups:group A (control group) and ischemia-reperfusion groups (B,C,D).The rabbits in the group B were subjected to left lateral stellate g anglion block.Myocardial ischemia/reperfusion injury model in vivo was establis hed routinely.HR,LVP,+dp/dtmax were measured and blood samplies were taken from coronary sinus for the determination of NPY,NE 10 min after thorax incision,befo re LAD crossclamping,and 5,30,90 min after reperfusion.Results The levels of NPY and NE were significantly reduced at 5,30,90 min after reperfusion (P<0.05),and LVP and +dp/dtmax were significantly elevat ed at 90 min after reperfusion (P<0.05) in group B.Conclusion Left lateral stellate ganglion block can protect the myocardium from i schemia-reperfusion injuny.