螺内酯对缺血再灌注损伤时心肌细胞凋亡的影响  

Effect of spironolactone on cardiomyocyte apoptosis during ischemic and reperfution period

作　　者：夏勇[1] 丁汝跃[1] 李东野[1] 陈清枝[1] 

机构地区：[1]徐州医学院附属医院心内科,江苏省徐州市221002

出　　处：《心肺血管病杂志》2007年第4期224-226,238,共4页Journal of Cardiovascular and Pulmonary Diseases

基　　金：江苏省社会发展基金资助项目(BS2002009);江苏省高校省级重点实验室开放课题(KJS04006)

摘　　要：目的:探讨螺内酯对心肌缺血再灌注损伤(I/R)时细胞凋亡的影响。方法:30只新西兰家兔随机分为3组:假手术(SHAM)组、缺血再灌注(I/R)组和制备I/R模型前应用螺内酯组(SPI)。测量左心室功能、光镜及电镜观察标本病理形态改变,免疫组化观察Bcl-2和Bax表达,缺口末端标记法(TUNEL)检测细胞凋亡程度。结果:1.I/R组心功能较SHAM组明显下降,SPI组较I/R组改善;2.SHAM组心肌结构完整,I/R组心肌结构损害严重,SPI组心肌结构损害较轻;3.SPI组Bcl-2表达阳性率高于SHAM组与I/R组,I/R组Bax阳性表达率高于SHAM与SPI组;4.TUNEL结果显示,I/R组细胞凋亡程度高于SHAM与SPI组。结论:螺内酯减轻I/R中心肌细胞凋亡程度。Objective：To investigate the effect of spironolactone on cardiomyocyte apoptosis during ischemic and reperfution period（I/R）. Method： Thirty New Zealand rabbits were randomly separated into three groups, the sham-operated group（ n = 10） was established without coronary artery ligation .The model of I/R group（ n = 10） was established by tighting two thread which went through Numier pipe for 45 minutes, then unclamped and reperfused for 4 hours.The SPI group（ n = 10） was established in the same way of I/R group with spironolactone （5 mg/kg^-1·d^-1 , bid） interference in a preoperative week. The MacLab LVDP ± dp/dtmax was compared within different groups. The pathological changes was observed by light and electron microscope. The exprssion of Bcl-2 and Bax protein in cardiomyocyte was observed using immuno-histochemistry. The cardiomyoeyte apoptosis was examined by TUNEL. Result： 1. Cardial function in I/R group was the lowest compared to other two groups, while cardial function of SPI group were higher than that of I/R group. 2. The cardiomyocytes injury was more severe in I/R group than in SPI group. 3 .The expression rate of Bcl-2 protein in SPI group was higher than that in I/R group, while the Bax was lower.4.The cardiomyoeyte apoptosis was lower in SPI group than that of I/R group. Conclusion ：Spironolactone may protect cardiomyocyte from I/R injury by decrease their apoptosis.

关 键 词：缺血再灌注损伤 螺内酯 细胞凋亡 动物实验 兔 

分 类 号：R542.2[医药卫生—心血管疾病] R541.61[医药卫生—内科学]