GIK对缺血/再灌注犬心肌超微结构的影响

目的:观察葡萄糖-胰岛素-钾液（GIK）、葡萄糖-钾液（GK）对急性心肌缺血/再灌注（MI/R）犬心肌缺血区内心肌细胞改变的影响，分析GIK中的胰岛素对MI/R心肌细胞的保护作用。 方法: 将犬心肌定量缺血(左前降支血流量降低80%) 50 min,再灌注4 h，建立犬MI/R模型。24只杂种犬随机分为GIK组、GK组和盐水对照组(n=8)，于再灌注前5 min，分别输注GIK、GK和生理盐水。再灌注4 h后，计算梗死区占缺血区重量的百分比，并制作电镜切片于透射电镜下观察。 结果: GIK可显著减少心肌梗死(MI)的范围［GIK组（5.2±0.8）% vs. 盐水对照组（9.4±0.8）%，P<0.05］；而GK组MI的范围（8.5±0.9）%则与盐水对照组无明显差异。与盐水对照组相比，GIK组对非缺血心肌的超微结构无影响，对缺血心肌有一定的保护作用。GK对缺血心肌无保护作用。结论: 再灌注时，静脉输注GIK可减轻心肌超微结构的损伤，其中的胰岛素是GIK上述作用的关键成分。

Effects of high-dose glucose-insulin-potassium(GIK) on ultramicrostructure in a canine model of myocardial ischemia and reperfusion

AIM: To study the effect of glucose-insulin-potassium(GIK) on changes of dog myocardial cells after ischemia-reperfusion injury following acute myocardial ischemia/reperfusion(MI/R) and to explore the role of insulin in the protective effects of GIK on myocardium.METHODS: In anesthetized open-chest dogs,the left anterior descending coronary artery(LAD) was partially occluded(80% reduction in its blood flow) for 50 min and reperfused for 4 h.Dogs were randomly divided into three groups: GIK,GK and saline.All...