心内膜下心肌缺血是目前医学界研究较活跃的问题之一。因心内膜下缺血往往涉及范围广泛

且易引起电不稳定

若治疗不当

其远期预后与穿壁型心肌梗塞者相同。但内膜下心肌梗塞往往在梗塞区内含有较多的存活心肌

因此

若处理及时

可望较好的恢复。临床上早就认识到中枢神经功能紊乱

能引起内膜下心肌缺血或梗塞

但其机理尚不清楚

一般认为

心电图 S-T段下移代表内膜下心肌缺血

但缺乏直接根据。Hoffman 和 buckberg 用标记有放射Thirty-two rabbits were anaesthetized with mixture of α-chloralose and urethane and ventilated with a volume controlled respirator.After midsternal thoractomy the heat was suspended in an open pericardical cradle.Left ventricular (LV) pressure was recorded through a fluid-filled catheter inserted into the left ventricle through LV apex.Aortic pressure was recorded through a fluid-filled catheter introduced into the ascending aorta through left carotid artery.Each catheter was connected to a blood pressure tranducer Pso.The epicardial electrocardiogram (EECG) was measured by a cotton wick—normal saline electrode.The LV and aortic pressure as well as EECG were recorded simultaneously on a polygraph RM-6000 at a paper speed of 100mm/sec. The diastolic pressure time index (DPTI)/tension time index (TTI) ratio and EECG S-T Segment changes were taken as the indices of LY transmural blood flow.DPTI/TTI and EECG S-T segment markedly depressed (P<0.01) during stimulation of dorsal median hypothalamus (DMH) with a pair of concentric electrode

with persisted at least 60 minutes after stopped stimulation of DMH.And this effect can be relived by synchronous stimulation of MN (P>0.05). This study indicated that DMH takes an important role in both inducing subendomyocardial ischemia and reliving subendomyocardial ischemia through stimulation of MN.