骨骼肌和心肌缺血后处理对兔缺血/再灌注心肌的保护作用  

Cardiac protection from myocardial ischemic postconditioning and remote postconditioning during myocardial ischemia/reperfusion injury in rabbits

作　　者：曹广运[1] 谢瑞芹[1] 崔炜[1] 刘凡[1] 刘静[1] 鲁静朝[1] 任慧敏[1] 呼海娟[1] 

机构地区：[1]河北医科大学第二医院心内科,石家庄055550

出　　处：《中国应用生理学杂志》2012年第5期476-480,共5页Chinese Journal of Applied Physiology

基　　金：河北省自然科学基金资助项目(C201000522)

摘　　要：目的:观察骨骼肌缺血后处理(RPostC)、心肌的缺血后处理(MPostC)对缺血/再灌注心肌保护作用是否存在差异以及两者联合后作用是否叠加。方法:健康新西兰大白兔3O只,随机分为5组(n=6):缺血对照组(Con)、假手术组(sham)、心肌缺血后处理组(MPostC)和肢体缺血后处理组(RPostC)及心肌缺血后处理联合肢体缺血后处理组(MPostC+RPostC)。采用开胸结扎冠状动脉左室支45 min,再灌注120min方法制作缺血/再灌注模型,采用短暂结扎双侧髂外动脉固定部位5 min造成骨骼肌短暂缺血。以Evans蓝标记心肌缺血区范围,以TTC法检测梗死心肌范围,并分别于缺血前、后及再灌注1、2 h测定血浆磷酸肌酸激酶(CPK)活性和乳酸脱氢酶(LDH)含量。结果:和Con组相比,MPostC和RPostC组心肌梗死范围均明显降低(P<0.05);MPostC联合RPostC组心肌梗死范围与MPostC或RPostC组相比,均进一步降低(均P<0.05)。但MPostC组及RPostC组之间心肌坏死范围未见统计学差异。再灌注120 min末血浆CPK活性及LDH含量也显示相似趋势。结论:骨骼肌缺血后处理及心肌后处理对缺血/再灌注心肌均具有明显保护作用;且两者作用可以叠加;但骨骼肌和心肌后处理之间保护作用未显示统计学差异。Objective： To observe whether there are some differences between myocardial postconditioning and remote postconditioning,and whether there is additional cardiac protection when they are used combined during myocardial ischemia/reperfusion injury in rabbits.Methods： Thirty healthy New Zealand rabbits which were randomly divided into 5 groups（n=5）： ischemic control group（CON）,sham operation group（Sham）,myocardial postconditioning group（MPostC）,remote postconditioning group（RPostC）,myocardial postconditioning plus remote postconditioning group（MPostC ＋ RPostC）.Acute myocardial infarction was induced by 45 minutes occlusion on left circumflex coronary artery（LCX） and 2 hours reperfusion in all anesthetized open-chest rabbits except the Sham,the coronary occlusion and reperfusion were determined by changes of ECG and cardiac color.Skeletal muscle ischemia model was induced by extrinsic iliac arteries occlusion and reperfusion with artery clamps.The condition that the extrinsic iliac arteries were occluded or reperfused could be tested by according to the distal arterial pulse.Plasma creatine kinase（CPK） activity and lactate dehydrogenase（LDH） activity were measured at baseline,the end of ischemia,after 1 hour and 2 hours of reperfusion respectively.The extent of myocardial infarction was assessed by triphenyltetrazolium（TTC） staining and measured by area ratio of AN/AAR.Results： Compared with the Con,myocardial infarct size was significantly reduced in MPostC and RpostC group（P〈0.05）.But there was no significant difference between MPostC and RPostC group.Combined MPostC and RPostC markedly enhanced myocardial protection（P〈0.05）.The trend of CPK and LDH release was similar to the trend of myocardial infarct size.Conclusion： Both MPostC and RPostC induced cardiac protection.There was no significant difference between MPostC and RPostC.Combined MPostC and RPostC induced markedly additive effect on myocardial protection.

关 键 词：骨骼肌 心肌缺血 缺血后处理 再灌注损伤 

分 类 号：R363.2[医药卫生—病理学]