阿片受体介导电针预适应对心脏的保护作用  

Involvement of opioid receptors in the protective effect of electroacupuncture preconditioning on myocardial ischemia-reperfusion injury in rats

作　　者：钟敏[1] 杨进辉 招伟贤[1] 谢晓澜[1] 

机构地区：[1]广东省中医院麻醉科,广州510120 [2]广东省广州市越秀区正骨医院麻醉科,510030

出　　处：《广东医学》2011年第6期685-687,共3页Guangdong Medical Journal

基　　金：广东省中医药管理局基金资助项目(编号:2008115)

摘　　要：目的探讨电针预适应对心肌缺血/再灌注(MI/R)损伤的保护作用,以及阿片受体在其中扮演的角色。方法采用结扎和再灌大鼠左冠状动脉前降支(LAD)的方法建立实验性心肌缺血/再灌注模型。雄性Wistar大鼠随机分为假手术对照(N)组、心肌缺血模型(M)组、心肌缺血模型+电针(EA)组和心肌缺血模型+纳洛酮+电针(EN)组。电针预适应方法是心肌缺血造模前连续3 d给予双侧内关穴电针,每次30 min。观察比较MI/R前电针处理对心电图ST段、心肌缺血面积的影响。实验结束摘取心脏,透射电镜下观察心肌组织线粒体的超微结构变化。结果与N组比较,M组在缺血15、30 min及再灌注10 min时ST段均明显抬高(均P<0.01);与M组比较,EA组ST段抬高幅度明显降低(均P<0.01),而EN组ST段抬高幅度与M组相近,均明显高于EA组(P<0.01)。以梗死区/危险区比值为指标的观察表明,M组梗死区/危险区比值为(54.4±7.5)%,EA组该比值明显低于M组(P<0.01),EN组该比值则与M组相仿,明显高于EA组(P<0.01)。透射电镜结果显示M组线粒体明显肿胀,呈典型空泡样变,嵴断裂;EA组线粒体肿胀程度较轻,嵴排列较整齐;EN组线粒体肿胀,嵴排列紊乱。结论电针预适应可以改善冠状动脉结扎引起的ST段抬高,减轻心肌缺血的程度,减少心肌梗死面积,减轻心肌线粒体超微结构的病理变化,阿片受体阻断剂纳洛酮可以抑制其保护作用。电针内关穴预适应对心肌缺血具有保护作用,阿片受体参与介导电针预适应改善心肌缺血性损害的作用。Objective To study the cardioprotective effects of electroacupuncture（EA） preconditioning on myocardial ischemia-reperfusion（MI/R）,and to evaluate the role of opioid receptors in this process.Methods The in vivo rat model of MI/R was constructed by occluding left anterior descending artery（LAD） for 30 min,followed by reperfusion for 120min.Male Wistar rats were randomly divided into Group N（sham-surgery control group）,Group M（MI/R group）,Group EA（MI/R plus EA group） and Group EN（combined MI/R,EA and naloxone group）.EA was applied at bilateral ＂Neiguan＂ for 30 min/d for 3 days.ST-segments in ECG and the ratio of infarct size/risk zone were detected.The myocardial sample of the left cardiac ventricle was collected for pathological observation of mitochondria under transmission electron microscope.Results ST-segment in ECG was significantly elevated 15 and 30 min after ischemia and 10 min after reperfusion in Group M,comparing with that in Group N（P0.01）.The elevated ST-segment was significantly reduced in Group EA,comparing with those in Group M and Group EN（P0.01）.Correspondingly,significantly higher ratios of infarct size/risk zone were observed in Group M and Group EN than that in Group EA（P0.01）.Meanwhile,mitochondrial swelling,reduction of mitochondrial cristae,and broken cristae with disordered arrangement and vacuous changes were observed in both Group M and EN,while milder pathological changes were presented in Group EA.Conclusion Pretreatment of EA protects the heart from injury of MI/R in rats,which maybe mediated by opioid receptors.

关 键 词：电针 预适应 心肌缺血再灌注 阿片受体 

分 类 号：R454.2[医药卫生—治疗学]