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【文摘发布】糖尿病药物能治疗心肌梗死

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Clin Exp Pharmacol Physiol. 2005 Oct;32(10):805-10. Links
The anti-diabetic drug miglitol is protective against anginal ischaemia through a mechanism independent of regional myocardial blood flow in the dog.Uno Y, Minatoguchi S, Arai M, Wang N, Chen XH, Hashimoto K, Lu C, Takemura G, Fujiwara H.
Department of General Internal Medicine, Gifu University School of Medicine, Gifu, Japan.

1. In the present study, we attempted to clarify whether the antidiabetic drug miglitol, an alpha-glucosidase inhibitor, has a protective effect against anginal ischaemia. We had reported previously that miglitol reduces myocardial infarct size through inhibition of glycogenolysis during ischaemia in rabbits. However, the effect of miglitol on anginal ischaemia remains unknown. 2. In open-chest beagle dogs with a severely stenosed left anterior descending coronary artery, an epicardial electrode was attached to the surface of the risk area of the left ventricle and a microdialysis probe was implanted into the myocardium to measure ST segment changes and interstitial lactate accumulation. The first episode of anginal ischaemia was induced by atrial pacing and phenylephrine infusion (50-100 microg/min) for 10 min. The second episode of anginal ischaemia was induced 210 min after the first episode. Miglitol (10 mg/kg, i.v.) was administered to the miglitol group (n = 10) 30 min before the second episode of anginal ischaemia, whereas saline was administered to the control group (n = 10). Regional myocardial blood flow was measured using coloured microspheres. 3. There was no significant difference in regional myocardial blood flow in the risk and non-risk areas between the first and second episodes of anginal ischaemia and between the miglitol and control groups. During the first and second episodes of anginal ischaemia, the ST segment was decreased to a similar extent in the control group. Although ST segment depression during the first episode of anginal ischaemia was similar in both groups, ST segment depression during the second episode of anginal ischaemia was significantly attenuated in the miglitol-treated group compared with the control group (1.3 +/- 0.4 vs 2.2 +/- 0.4 mV, respectively). Miglitol significantly attenuated myocardial interstitial lactate accumulation in the risk area. 4. In conclusion, in the present study miglitol improved ST segment depression and attenuated the accumulation of myocardial interstitial lactate during anginal ischaemia without altering regional myocardial blood flow. Miglitol has an anti-anginal ischaemia effect via a mechanism that is independent of regional myocardial blood flow.

PMID: 16173940 [PubMed - indexed for MEDLINE]

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2008-06-18 16:37 浏览 : 555 回复 : 2

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• 关于调剂你了解多少？

arzt_lee

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本人已领译，48小时内递交，若逾时请别的战友认领，谢谢！

2008-06-20 19:01

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• 大量失血输血治疗后会引起急性心梗吗？

arzt_lee

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我们目前的研究是为了阐明糖尿病药物米格列醇，一种α-糖苷酶抑制剂，是否对于缺血性心绞痛有预防作用。我们以前曾经报道过，在兔实验中，米格列醇可以通过在缺血实验中抑制糖苷酶的活性来减小心肌梗死的面积。但是米格列醇对于缺血性心绞痛的作用还是不清楚。在对于冠状动脉前降支有严重狭窄的小猎犬的开胸手术中，我们将一个心外膜电机放置在左心室有可能梗死的区域，同时也将一个微量渗析探针植入心肌层去测量ST段的改变和间质中的乳酸盐含量。缺血性心绞痛的第一期是由心房起搏和苯肾上腺素灌注10分钟（50-100 mg/min¬）诱导的。第二期是在第一期的210分钟后发生的。在米格列醇组（n=30），药物（10mg/kg i.v）是在缺血性心绞痛第二期发生30分钟前给予的，然而在控制组（n=10）中式给予的保护液。局部心肌血流是由彩色中心体测量的。在缺血性心绞痛的第一和第二期，药物组合控制组的危险区和非危险区的局部心肌灌流都没有明显差别。在缺血性心绞痛的第一和第二期，药物组的ST段也降到了与控制组相当的水平。尽管在第一期，两组的ST段下降都相当，但是在第二期中，药物组的的下降幅度明显小于控制组(1.3 +/- 0.4 vs 2.2 +/- 0.4 mV)。米格列醇显著地降低了危险区间质中的乳酸盐的含量。结论：在以前的研究中，由于没有改变区域心肌的血流，米格列醇增加了ST段的下降，减少了心肌间质中的乳酸盐含量。米格列醇是通过一种不依赖局部心肌血流的机制来控制缺血性心肌梗死。

2008-06-21 19:26

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• 考研初试成绩即将公布，你有什么想说的？

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