缺血-再灌注心脏自主神经功能失衡与交感神经活性的相关分析及干预  

ANALYSIS OF THE CORRELATION BETWEEN AUTONOMIC NERVES IMBALANCE AND THE ACTIVITY OF SYMPATHETIC NERVE IN THE ISCHEMIA-REPERFUSION HEART AND THE INTERVENTION ON IT

作　　者：郑少玲[1] 李穗鸥 朱尚文[2] 朱海斌[3] 

机构地区：[1]广东省第二人民医院,广东广州510317 [2]广州市白云区人民医院,广东广州510500 [3]广州军区广州总医院一五七医院,广东广州510510

出　　处：《现代医院》2012年第2期16-18,共3页Modern Hospitals

基　　金：广东省自然科学基金(编号:10151001002000017)

摘　　要：目的分析兔缺血-再灌注心脏自主神经功能失衡与交感神经活性的相关性,评估极化液(GIK)、美托洛尔的干预作用。方法 60只新西兰兔,通过结扎兔冠状动脉左室支(LAD)复制动物缺血-再灌注模型,分析心肌缺血-再灌注中HRV和血浆去甲肾上腺素(NE)、肾上腺素(N)、肾素活性(PRA)和血管紧张素Ⅱ(AngⅡ)的变化,给予GIK、美托洛尔及其合用,观察其对HRV和血浆NE、N、NPR、AngⅡ的影响,各指标间进行相关性分析及对比研究。结果 LAD阻断后交感神经活性占优势,血浆NE、N、PRA和AngⅡ增加,而HRV各项指标减少,存在心脏自主神经失衡,HRV与血浆NE、N、PRA和AngⅡ有明显的相关性。GIK及美托洛尔能明显增加心肌缺血-再灌注后HRV各项指标,改善交感活性。二药合用效果更佳,并能显著降低血浆NE、N、PRA和AngⅡ(p<0.01)。结论本实验表明GIK、美托洛尔有抑制缺血-再灌注心脏的交感神经活性,维持心脏自主神经功能平衡的作用,这可能是保护缺血-再灌注心脏,防治心脏性猝死的重要机制之一。Objective To investigate the prevention of glucose-insulin-potassium（GIK） and metoprolol on the autonomic nerves imbalance and the relation between autonomic nerves dysfunction and sympathetic nerve activity in rabbit ischemia-reperfusion heart. Methods Model of myocardial ischemia-reperfusion injury made by ligating left anterior descending artery（LAD） in rabbit is used,and analyze the variation of HRV,noradrenalin（NE）,adrenaline（N）,plasma renin activity（PRA）and angiotensin II（AngⅡ）in myocardial ischemia-reperfusion injury.The intervention on the affect of them introduced with glucose-insulin-potassium（GIK）,metoprolol or concomitant of them.Data is used in Correlations and Comparative analysis. Results The activity of sympathetic nerve is superiority after LAD blocked.It is increased of NE,N,PRA and AngⅡ,while decreased the data of HRV,and lead to autonomic nerves dysfunction in heart.There is significant relations among HRV,NE,N,PRA and AngⅡ.GIK and metoprolol can increase the data of HRV after myocardial ischemia reperfusion injury,and improve the activity of sympathetic nerve.Both GIK and metoprolol or used together can reduced NE,N,PRA and AngⅡ observably（p0.01）. Conclusion GIK,metoprolol have the ability of restraining the activity of sympathetic nerve in ischemia reperfusion heart,and retain the function of autonomic nerves.This mechanism should protect the ischemia reperfusion heart and avoid sudden cardiac death.

关 键 词：心肌缺血-再灌注 自主神经 去甲肾上腺素 肾上腺素 肾素活性 血管紧张素Ⅱ GIK 美托洛尔 

分 类 号：R282.71[医药卫生—中药学]