血红素氧合酶对复苏后心功能不全的保护作用  

Protective role of heine oxygenase in myocardial dysfunction postresuscitation

作　　者：王晓红[1] 方向韶[1] 黄子通[1] 符岳[1] 李文静[1] 

机构地区：[1]中山大学附属第二医院急诊科中山大学心肺脑复苏研究所,广州510120

出　　处：《中华急诊医学杂志》2009年第4期380-385,共6页Chinese Journal of Emergency Medicine

基　　金：基金项目：国家自然科学基金资助项目（30700303）;广东省自然科学基金资助项目（8151008901000100）

摘　　要：目的探讨诱导血红素氧合酶表达对复苏后心肌损伤的保护作用，为复苏后心功能不全探索新的治疗手段。方法采用窒息法制作大鼠心跳骤停与心肺复苏（CPR）模型。实验动物分为4组：假手术组、CPR组、血晶素组（Hemin组）、血晶素＋锌原卟啉组（Heroin＋ZnPP组），各复苏组又分复苏后6h及24h2个亚组。各实验组记录血流动力学资料；测定血清肌酸肌酶同功酶（CPK-MB）、乳酸脱氢酶（LDH）含量；测定心肌组织匀浆HO-1含量；观察心肌超微结构变化。对结果进行方差分析。结果各复苏组复苏后平均动脉压（MBP）显著低于复苏前（均P〈0．05），但组间比较差异无统计学意义。CPR组、Heroin＋ZnPP组复苏后各时相点dp／dt40值、-dp／dt值均显著低于复苏前（P〈0．05），但Heroin组复苏前后dp／dt40值无显著性变化，-如／dt值仅复苏后0．5h和1h低于复苏前（P〈0．05）；Hemin组复苏后各时相点dp／dt40值、-dp／dt值均高于其他两组（P〈0．05）。复苏后6h及24h血清CPK-MB、LDH水平，Hemin组均低于CPR组及Heroin＋ZnPP组（P〈0.05），但CPR组和Heroin＋ZnPP组两组之间比较差异无统计学意义。Hemin组复苏后6h心肌超微结构完整性明显优于CPR组及Heroin＋ZnPP组。复苏后6h及24h心肌组织匀浆HO-1水平，Heroin组均高于CPR组及Heroin＋ZnPP组（均P〈0．05），但CPR组和Hemin＋ZnPP组两组之间差异无统计学意义（P〉0．05）。结论诱导HO-1表达可有效改善复苏后心功能不全，减轻心肌损伤，保存心肌细胞超微结构的完整性，为复苏后心功能不全的治疗提供了新的手段。Objective To study the cardioprotection effects of heme oxygenase-1 （ HO-1 ） on cardiopulmonary resuscitation（CPR）. Method Male Sprague-Dawley rats were asphyxiated for 9 minutes and resuscitated. Rats were randomly divided into 4 groups, namely, sham asphysiation group, CPR group, Heroin group and Heroin ＋ ZnPP group （zinc protoporyphyrin IX）. Resuscitated groups were further divided into two subgroups according to various intervals：6 hours and 24 hours after resuscitation. Hemodynamic was observed. Serum creatine phosphokinase-MB（CPK-MB） and lactate dehydrogenase were determined. HO-1 in heart tissue homogenates was assayed. Uhrastructure of rats hearts was examined. Statistical evaluation was performed with analysis of variance. Results The mean blood pressure （MBP） in resuscitated groups was significantly reduced after resuscitation, hadn＇t any difference between supgroups. The scores of dp/dt40 and - dp/dt were significantly decreased in CPR group and Hemin ＋ ZnPP group after resuscitation （all P 〈 0.05）, but dP/dt40 in Hemin group did not differ significantly after resuscitation, and - dp/dt decreased only 0.5 hours and ont hour after resuscitation and returned to baseline values two hours after resuscitation. The scores ofdp/dt40 and - dp/dt in Hemin group at different intervals after resuscitation were significantly higher than those in CPR group and Hemin ＋ ZnPP group （ all P 〈 9.05）. Serum CPK-MB and LDH in CPR group and Hemin ＋ ZnPP group at 6 hours and 24 hours after resuscitation were significantly higher than those in Hemin group （all P 〈 0.05）. The cardiac tissue uhrastructure of rats in Hemin group was more intact than that of CPR group and Heroin ＋ ZnPP group. HO-1 levels in heart tissue homogenates of Hemin group at 6 hours and 24 hours after resuscitation were significantly higher than those in CPR group and Hemin ＋ ZnPP group （all P 〈 0.05）. Conclusions HO-1 expression induced by Hemin can effectively improve post-resuscitation myoca

关 键 词：血红素氧合酶 心肺复苏 心功能不全 大鼠 

分 类 号：R459.7[医药卫生—急诊医学]