急性脑损伤致心肌损害的内源性NE及心肌β1—AR变化  

Endogenetic NE and myocardial β1- AR in the myocardial damage after acute brain injury

作　　者：郭彩霞[1] 张立克[2] 王红霞[2] 芦玲巧[2] 杜凤和[1] 

机构地区：[1]首都医科大学附属北京天坛医院心内科,北京100050 [2]首都医科大学病理生理教研室,北京100054

出　　处：《中国急救医学》2010年第3期234-237,共4页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金资助项目（No.30740054）

摘　　要：目的探讨急性脑损伤（acute brain injury，ABI）致心肌损害的内源性去甲肾上腺素（noradrenaline，NE）和β1肾上腺素受体（adrenalin β1 receptor，β1—AR）变化，为了解ABI致心肌损害的发生机制提供理论依据。方法采用动物模型观察肌酸磷酸激酶同工酶（MB isoenzyme of creatine kinase，CK—MB）含量判断心肌损害与否及损伤程度，采用高效液相色谱-电化学检测（（ high performance liquid chromatogramphy - electrical conductivity detector, HPLC - ECD）测定血浆及心肌组织NE水平，观察1、6、24和48h时间点的变化。采用反转录多聚酶链反应（reverse tran-scriptase polymerase chain reaction, RT- PCR）和实时定量反转录多聚酶链反应（real-time RT-PCR，rt-RT—PCR）测定β1-ARmRNA表达。实验分为正常组、假手术组、ABI组和β1肾上腺素受体阻断剂（adrenalin β1 receptor blocker, β1 - ARB ）组。结果ABI致心肌损害表现为CK—MB含量显著增加（P〈0．05），脑损伤后24h心肌损害最严重。血浆和心肌组织NE水平显著升高（P〈0．05），血浆NE水平与CK—MB含量呈正相关（P〈0．05）。ABI及预先应用β1-AR阻断剂后心肌组织β1-ARmRNA表达与对照组相比差异元统计学意义。结论ABI可导致心肌损害的发生，可增加内源性NE，NE可能是参与急性脑损伤后心肌损害的机制之一。Objective To discuss changes of endogenetic NE and myocardial β1 - AR in the myocardial damage after acute brain injury（MDABI） for better understanding the mechanism. Methods Acute brain injury（ABI） rat model was induced. CK- MB in serum was measured to indicate the degree of myocardial damage. NE in plasma and myocardium were detected by HPLC - ECD. Changes were observed in4 time point including 1 h, 6 h, 24 h and 48 h after ABI. Expression of β1 - AR mRNA was determined by RT - PCR and real - time RT - PCR. There were four groups in the experiment including normal, sham, ABI and β1 -ARB group. Results CK- MB increased in the MDABI. The most severe myocardial damage happened in 24 hours after ABI. NE in plasma and myocardium increased significantly（ P 〈 0. 05 ）. Positive correlation was found between NE in plasma and CK- MB（P 〈 0. 05 ）. There was no significant difference of myocardial β1 -AR mRNA between ABI group and SHAM group. Same result happened between β1 - ARB group and SHAM group. Conclusion ABI can lead to myocardial damage. The endogenetic NE increased in the ABI, which maybe one of the mechanism of MDABI.

关 键 词：急性脑损伤 心肌损害 NE Β1-AR 

分 类 号：R651.15[医药卫生—外科学]