• 作者： 李應紹; 陳穎從; 林君柔; 吳真珮; 陳寬喜
• 作者服務機構： 臺中榮民總醫院醫研部及心臟內科
• 中文摘要： 已有報導，內生性鴉片樣在心血管系統及心肌缺血病生理機轉上扮演重要角色。本研究利用心導管術進一步探討鴉片對抗劑（納洛酮）在心肌缺血再灌流時對心臟血行力學及心室功能的影響。對照組狗隻在經過冠狀動脈結紮再灌流時，主動脈、左心室、右心房、肺動脈及肺楔壓力，及左心室收縮力（dp/dt）皆下降。納洛酮則能有意義地減少主動脈及左心室壓及左心室收縮力下降。研究結果指出內生性鴉片樣具心血管調控作用，及在心肌缺血再灌流時導致不良之心臟血行力學及心室功能，而納洛酮對血行力學及心室功能之改善作用，是經由抑制鴉片受體之影響。所以鴉片抗劑可能對心肌缺血性心臟疾病具預防及治療價值。
• 英文摘要： It has been shown that endogenous opioid peptides (EOP) subserve important roles in cardiovascularregulation and are involved in the pathophysiology of myocardial ischemia, contributing to the deleteriouseffects. The aim of this study was to evaluate the effects of the opiate antagonist naloxone on the hemody-namics and ventricular function following coronary artery occlusion and reperfusion in the dog, utilizingthe technique of cardiac catheterization. During myocardial ischemia and reperfusion, it was found thatin the control group, there was reduction in the aortic, left ventricular, right atrial, pulmonary arterial andwedge pressures, and in the left ventricular dP/dt. The reduction in the aortic, left ventricular and pulmonaryarterial pressures, and left ventricular dP/dt were significantly attenuated by pretreatment with naloxone.The results indicate a regulatory role of EOP in the cardiovascular function and suggest a possible involve-ment of EOP in myocardial ischemia and reperfusion causing detrimental effects such as arrhythmias, brady-cardia, hypotension and, as shown in this study, impaired hemodynamics and ventricular function. Thebeneficial effects of naloxone on circulatory dynamics may have clinical implications in the prevention andtreatment of ischemic heart disease.
• 中文關鍵字： endogenous opioid peptide; opiate antagonist; naloxone; hemodynamics; ventricular function; myocardial ischemia and reperfusion.
• 英文關鍵字： --