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摘要：
目的 探讨针刺对慢性心肌缺血大鼠麻醉诱导期血流动力学的影响。 方法 SPF级雄性SD大鼠45只，体重200~250 g，按随机数字表法分为3组（每组15只）：正常对照组（NC组）、慢性心肌缺血组（HR组）和针刺组（A‑HR组）。制作心肌缺血模型针刺干预4周后，颈静脉给予0.1% 异丙酚9 mg/kg麻醉诱导，测量平均颈动脉压（mean arterial pressure，MBP）、左室收缩压（left ventricular systolic pressure, LVSP）、左室舒张末压（left ventricular end‑diastolic pressure, LVEDP）、左室压力最大上升/下降速率（maximal rate of rise/decline of left ventricula pressure, ±dp/dt）和心率，以及超氧化物歧化酶（superoxide dismutase, SOD）、丙二醛（malondiadehyde, MDA）、肌酸激酶同工酶（creatine kinase isoenzyme, CK‑MB）和心肌组织形态学改变等。 结果 与NC 组比较，HR 组LVSP、±dp/dt、SOD水平和MBP明显降低（P<0.05），LVEDP和心率明显升高，血浆CK‑MB和MDA的含量明显升高（P<0.05），心肌损伤严重；与HR组比较，A‑HR组LVSP、+dp/dt和MBP明显升高，心率明显降低（P<0.05）。与HR组比较，A‑HR组血浆CK‑MB和MDA的含量明显降低（P<0.05），SOD明显升高（P<0.05），心肌损伤较轻，结构更为完整。 结论 针刺预处理心肌缺血大鼠可能是通过抑制脂质过氧化改善心肌微循环，减轻心肌损伤，从而调控麻醉诱导期血流动力学稳定性。
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Abstract: Objective To investigate the effect of acupuncture on hemodynamics in chronic myocardial ischemia rats during induction of anesthesia. Methods Forty five Sprague‑Dawley rats, weight 200‒250 g, were divided into three groups according to a random number table (n=15): a normal control group (group NC), a chronic myocardial ischemia group (group HR) and an acupuncture group (group A‑HR). After acupuncture intervention of myocardial ischemia modeled animals for four weeks, the rats received induction of anesthesia with 0.1% propofol at 9 mg/kg via the jugular vein. Subsequently, the mean arterial pressure (MBP), left ventricular systolic pressure (LVSP), left ventricular end‑diastolic pressure (LVEDP), the maximal rate of rise/decline of left ventricula pressure (±dp/dt), heart rate, and superoxide dismutase (SOD), malondialdehyde (MDA), creatine kinase isoenzyme (CK‑MB) and the morphological changes of myocardial tissues were measured. Results Compared with those in group NC, LVSP, ±dp/dt and MBP remarkably declined in group HR (P<0.05), while LVEDP and heart rate significantly increased in group HR (P<0.05). Compared with group HR, group A‑HR presented significantly increased LVSP, +dp/dt and MBP (P<0.05) and significantly decreased heart rate (P<0.05). Compared with group HR, group A‑HR produced remarkable decreases in MDA and CK‑MB (P<0.05) and marked increases in SOD (P<0.05). Conclusions Acupuncture pretreatment of rats with myocardial ischemia can regulate and control hemodynamic stabilities during induction of anesthesia, which may be done through inhibiting lipid peroxidation to improves cardiac micro‑circulation and reducing the injury of cardiac muscles.
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