迷走神经电刺激后处理联合肢体远隔缺血后处理对大鼠心肌缺血再灌注损伤的影响  

Effects of combined vagus nerve electric stimulation postconditioning and limb remote ischemic postconditioning on myocardial ischemia-reperfusion injury in rats

作　　者：王强[1] 薛富善[1] 袁玉静[1] 李杉[1] 熊军[1] 程怡[1] 李瑞平[1] 廖旭[1] 刘建华[1] 

机构地区：[1]中国医学科学院北京协和医学院整形外科医院麻醉科,100144

出　　处：《中华麻醉学杂志》2011年第11期1353-1358,共6页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金（81170128）;北京协和医学院协和青年科研基金

摘　　要：目的评价迷走神经电刺激后处理联合肢体远隔缺血后处理对大鼠心肌缺血再灌注损伤的影响。方法雄性SD大鼠100只，8周龄，体重250～350g，采用随机数字表法，将其随机分为5组（n=20）：假手术组（S组）、缺血再灌注组（I／R组）、迷走神经电刺激后处理组（POES组）、肢体远隔缺血后处理组（RP组）、迷走神经电刺激后处理联合肢体远隔缺血后处理组（POES-RP组）。I／R组、POES组、RP组和POES-RP组采用结扎冠状动脉左前降支30min和再灌注120min的方法制备心肌缺血再灌注损伤模型。POES组和POES．RP组于心肌缺血15min时对右侧迷走神经干实施电刺激30min，电刺激参数：波宽2ms，频率10Hz，电流强度随HR进行调整，以保持HR较刺激前降低10％。RP组和POES—RP组于心肌缺血20min时采用止血带结扎双后肢10min后恢复血流灌注。各组随机取10只大鼠，于再灌注120min时采集颈动脉血样，采用ELISA法检测血清cTnI、CK-MB、TNF-α、高迁移率组蛋白1（HMGBl）、细胞间粘附分子1（ICAM．1）、IL-1、IL-6和IL-10的浓度；颈动脉采血后，采用伊文氏蓝和TIC双重染色法测定心肌梗死体积。再灌注120min时，各组随机处死10只大鼠，取缺血区和非缺血区心肌组织，采用ELISA法检测TNF-α、HMGB-1、ICAM-1、IL-1、IL-6和IL-10的含量。结果与S组比较，I／R组心肌梗死体积、血清cTnI、CK-MB、TNF-α、HMGB1、ICAM-1、IL-1和IL-6的浓度升高，缺血区和非缺血区心肌组织TNF-α、HMGB1、ICAM-1、IL-1、IL-6和IL-10的含量升高（P〈0．05）。与I／R组比较，POES组、RP组POES-RP组心肌梗死体积、血清cTnI、CK-MB、TNF-α、HMGB1、ICAM-1、IL-1和IL-6的浓度降低，缺血区和非缺血区心肌组织TNF—α、HMGB1、ICAM-1、IL-1和IL-6的含量降低，POES组和POES—RP组缺血区和非缺血区心肌组织IL-10含量升高（P〈0．05）。与POES组比较，POES-RP组心肌梗死体积、�Objective To evaluate the effects of combined vagus nerve electric stimulation postconditioning and limb remote ischemic postconditioning on myocardial ischemia-reperfusion （I/R） injury in rats. Methods One hundred male SD rats aged 8 weeks weighing 250-350 g were randomly allocated into 5 groups （ n = 20 each） ： sham operation group （group S）; I/R group; vagus nerve electric stimulation postconditioning group （group POES） ; limb remote isehemic postconditioning group （group RP） and vagus nerve electric stimulation postconditioning ＋ limb remote ischemic postconditioning group （group POES-RP）. Myocardial I/R was induced by occlu- sion of left anterior descending branch （LAD） of coronary artery for 30 rain followed by 120 min reperfusion in groups I/R, POES, RP and POES-RP. In groups POES and POES-RP, right cervical vagus nerve trank was stimulated for 30 min with continuous electric rectangular pulses （2 ms, 10 Hz） starting from 15 min of myocardial ischemia. The voltage of the pulses was adjusted to decrease HR by 10 % of the baseline HR before stimulation. In groups RP and POES-RP the animals underwent 10 min ischemia of bilateral hind limbs starting from 20 min of myocardial ischemia. Arterial blood samples were collected from 10 rats in each group at 120 min of reperfusion for determination of serum concentrations of cTnI, CK-MB, TNF-α, high mobility group box 1 protein （HMGB1）, intercellular adhesion molecule-1 （ICAM-1）, IL-1, IL-6 and IL-10 （by ELISA）. The animals were then sacrificed and myocardial infarct size was measured by Evans blue and TTC staining. Another 10 rats were sacrificed at 120 rain of reperfusion for determination of myocardial contents of TNF-α, HMGB-1, ICAM-1, ILl, IL-6 and IL-10 （by ELISA）. Results I/R induced myocardial infarct and significantly increased serum concentrations of cTnI, CK-MB, TNF-α, HMGB1, ICAM-1, IL-1 and IL-6 and increased myocardial contents ofTNF-α, HMGB1, ICAM- 1, IL-1, IL-6 and IL-10 in both ischemic and non-

关 键 词：电刺激 迷走神经 后肢 心肌再灌注损伤 缺血后处理 

分 类 号：R363[医药卫生—病理学]