外源性磷酸肌酸钠对缺血再灌注骨骼肌保护机制的实验研究  

Protection mechanism of creatine phosphate on ischemia reperfusion of skeletal muscle: Experimental study

作　　者：丁明[1] 李大鹏[1] 王昕辉[1] 刘明明[2] 

机构地区：[1]89医院麻醉科,山东潍坊261021 [2]潍坊医学院,山东潍坊261000

出　　处：《实用医药杂志》2012年第7期627-629,633,共4页Practical Journal of Medicine & Pharmacy

摘　　要：目的探讨外源性磷酸肌酸钠对缺血再灌注肢体的保护作用。方法健康成年家兔40只,随机分为对照组、缺血再灌注组(IR)、低浓度磷酸肌酸钠组(LCP)和高浓度磷酸肌酸钠组(HCP),每组各10只。制备兔左后肢缺血再灌注损伤动物模型。在即将恢复血流灌注时,各组分别经耳缘静脉注射生理盐水和不同浓度的磷酸肌酸钠溶液,在再灌注前、后不同时间点上经右侧颈内静脉取血测定血清乳酸脱氢酶(LDH)、天冬氨酸氨基转移酶(AST)、丙二醛(MDA)的含量及超氧化物歧化酶(SOD)活力。取胫前肌用免疫组织化学方法测肌肉中Bax和Bcl-2的变化情况,并在电镜下观察肌细胞超微结构变化。结果 LCP和HCP组再灌注后LDH、AST、MDA显著低于IR组(P<0.01),SOD活力高于IR组(P<0.01),HCP组较LCP组变化显著(P<0.05);LCP组和HCP组较IR组Bcl-2表达显著增强,Bax表达相对减弱,Bcl-2/Bax比值显著升高(P<0.01),HCP组较LCP组变化显著(P<0.05)。电镜下观察LCP和HCP组骨骼机损伤轻于IR组。结论外源性磷酸肌酸钠能够保护缺血再灌注骨骼肌。Objective To study the protection mechanism of creatine phosphate on ischemia reperfusion of skeletal muscle. Methods The experimental models of ischemia referfusion injury in extremities were established in 40 healthy adult rabbits, which were randomly divided into control groups, reperfusion groups, low concentration groups and high concentration groups （10 rabbits, each group）. Isolated left hindlimb of rabbits were used as ischemia-reperfusion models. Normal saline injection, creatine phosphate 0.Sg and lg were infused intravenously into the three groups just before blood reperfusion. At the points of preischemia, later 1 and 4 hours after reperfusion,the blood samples from the right internal carotid veins were collected respectively for measurements of lactic dehydrogenase（LDH）, aspartate aminotransferase（AST）, malondialdehyde（MDA） and superoxide dismutase（SOD）. The immunohistochemistry （IHC） method was used to detect the level in the expression of Bc1-2 and Bax. Meanwhile, the tibialis anterior muscles were harvested for examination of＂ the micro-structure and the uhrastructure by using electron microscope. Results After reperfusion, the contents of AST, LDH, MDA significantly decreased and the activity of SOD obviously increased in the HCP and LCP groups compared with reperfusion group（P〈0.01）, and HCP group was more obvious than LCP group（P〈0.05）. The expression of Bcl-2 protein was more in HCL and LCP than IR, so the expression of BAX was less, and Bcl-2/BAX was increased （P〈0.01）. The electron microscopy showed severe tissue injury in the reperfusion group but mild in HCP and LCP groups after reperfusion. Conclusion Creatine phosphate has a significant protective effect on ischemia reperfusion injury in extremities.

关 键 词：外源性磷酸肌酸钠 骨骼肌 再灌注损伤 

分 类 号：R614.3[医药卫生—麻醉学]