杏丁注射液對兔嚴重心肌挫傷的治療作用

作者：牛義民，劉達興，劉日輝，周繼紅
【關鍵詞】 心臟損傷
Experimental studies on treatment of severe myocardial contusion with Xingding injection in rabbits
　　【Abstract】 AIM: To explore the role of Xingding injection (XDI), an injection made of traditional Chinese medicinal herbs, in the treatment of myocardial contusion in rabbits. METHODS: Thirty rabbits were randomly divided into three groups: control group with falseimpact (control group, n=10), severe myocardial contusion group (MC group, n=10) and XDI treatment group (XDI group, n=10). The models of rabbit with severe myocardial contusion were made by BIMII Horizontal Bioimpact Machine. At 5 min before impact and 5 min, 30 min, 2, 4, 8 and 24 h after impact, blood samples were taken from common carotid artery of rabbits in each group to measure the concentrations of plasma thromboxane A2 (TXA2) and prostacyclin (PGI2) by radioimmunoprecipitation. At the end of the experiment, the heart of one rabbit from each group was harvested to observe the microstructural changes and 2 hearts were randomly taken from each group to observe ultrastructural changes. RESULTS: The concentrations of plasma PGI2 had a distinct fallingoff while the contents of plasma TXA2 were significantly higher in the early period of severe myocardial contusion (at 4 h after myocardial contusion). The morphological injuries of myocardial tissues were severe. With XDI, the reduction of the concentrations of plasma PGI2 and the increase of the contents of plasma TXA2 were significantly relieved. The morphological injuries of myocardial tissues were obviously lessened. CONCLUSION: Xingding injection can improve the reduction of the concentrations of plasma PGI2 and the increase of the contents of plasma TXA2 in the early period of severe myocardial contusion, which may concentrate to its therapeutic effect on severe myocardial contusion.
　　【Keywords】 heart injuries; contusions; PGI2; TXA2; Xingding injection
　　【摘要】 目的： 探討杏丁注射液對心肌挫傷的治療作用，為臨床救治心肌挫傷提供實驗依據(jù). 方法： 利用BIMII型生物撞擊機制備兔嚴重心肌挫傷模型；并用杏丁注射液進行治療作為對照. 分別于撞擊前5 min，撞擊后5， 30 min， 2， 4， 8， 24 h采頸總動脈血檢測血栓素A2（ TXA2）、前列環(huán)素（PGI2）的含量；于傷后24h摘取心臟作光鏡檢查，隨機取2只兔心作電鏡檢查，觀察心肌組織形態(tài)學改變. 結果： 血漿PGI2濃度在傷后早期（傷后4 h）明顯下降，而血漿TXA2濃度則明顯升高. 形態(tài)學檢查心肌組織損傷較重. 用杏丁注射液治療后血漿PGI2濃度降低和TXA2濃度升高都較輕，心肌組織損傷也明顯減輕. 結論： 杏丁注射液對心肌挫傷有治療作用，其機制可能與杏丁注射液升高血漿PGI2濃度和降低TXA2濃度有關.
　　【關鍵詞】 心臟損傷；挫傷； PGI2； TXA2；杏丁注射液
　　0引言
　　心肌挫傷(myocardial contusion, MC)是指鈍性暴力所引起的無原發(fā)心臟破裂或心內結構損傷的心臟創(chuàng)傷［1］，可發(fā)生于交通事故中，亦可發(fā)生于高處墜落、胸部受擠壓及運動時［2］. MC后常引起程度不等的心臟并發(fā)癥，如低心排出量、低血壓、傳導異常、血心包、心源性休克等［3］，嚴重威脅傷員的生命. 然而，目前臨床對MC的治療尚缺乏有效的藥物. 我們探討杏丁注射液對MC有無治療作用，為臨床救治MC提供實驗依據(jù).
　　1材料和方法

　　1.1材料
　　健康家兔30只，雌雄兼用，體質量（2.5±0.3） kg，分成3組，每組10只. A組： 正常對照組（control group），除為偽撞擊（胸壁向內壓縮0 cm)外，余均同B組； B組: MC組（MC group），撞擊后立即給予生理鹽水4 mL/kg iv，并24 h輸液以維持兔循環(huán)穩(wěn)定；C組: 杏丁注射液治療組（Xingding group），除撞擊后立即給予杏丁注射液（貴州益佰制藥股份有限公司，每5 mL含銀杏總黃酮 4.5~5.5 mg，雙密達莫1.8~2.2 mg） 4 mL/kg iv外，余均同B組. 采用BIMII型水平式生物撞

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