缺血预处理和肢体远隔缺血后处理对大鼠心肌缺血／再灌注损伤中炎症反应影响的比较  

Comparison of the effects of ischemic preconditioning and limb remote ischemic postconditioning on inflammatory responseduring myocardial ischemia/reperfusion injury in rats in vivo

作　　者：王强[1] 李杉[2] 薛富善[2] 袁玉静[2] 熊军[2] 程怡[2] 李瑞萍[2] 廖旭[2] 刘建华[2] 

机构地区：[1]北京大学人民医院麻醉科,100044 [2]中国医学科学院北京协和医学院整形外科医院麻醉科

出　　处：《国际麻醉学与复苏杂志》2013年第3期224-229,共6页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金资助项目（30972836）

摘　　要：目的比较缺血预处理（ischemiCpreconditioning，IPC）和肢体远隔缺血后处理（1imbremoteischemicpostconditioning，LRIPOC）对大鼠心肌缺血，再灌注损伤（ischemia／reperfusioninjury，I／RI）中炎症反应的影响。方法雄性sD大鼠80只，体重250g-350g，采用随机数字表法将其随机分为4组（每组20只）：假手术组（s组）、缺血／再灌注组（I/R组）、IPC组和LRIPOC组。监测缺血／再灌注期间的心率（HR）和平均动脉压（MAP），并计算HR和收缩压乘积（ratepressureproduct，RPP）作为心肌氧耗指数。各组随机取10只大鼠，于再灌注30、60、120min时采集颈静脉血样，采用ELISA法检测血清心肌肌钙蛋白（cardiactroponinI，cTnI）、磷酸肌酸激酶同工酶（creatinekinase-MB，CK-MB）、肿瘤坏死因子（tumornecrosisfactor，TNF）诎、高迁移率组蛋白．1（highmobilitygroupbox-1protein，HMGB-1）、细胞间黏附分子．1（intercellularadhesionmolecule-1，ICAM．1）、白介素（interleukin，IL）-1、IL-6和IL．10的浓度；于再灌注120min颈静脉采血后，采用伊文蓝和TIC双重染色法测定心肌梗死体积。各组随机取10只大鼠，于再灌注120min处死后分别取缺血区和非缺血区心肌组织，采用ELISA法检测心肌TNF-a、HMGB-1、ICAM-1、IL-1、IL-6和IL-10含量。结果I／R组、IPC组和LRIPOC组的心肌梗死体积值分别是（72±9）％、（36±13）％和（57~9）％，3组的血清cTnI浓度分别是（0．99±0．14）（0．37±0．08）、（0．54±0．07），而3组的血清CK-MB浓度分别是（110±13）、（38±8）、（45±6）μg／L。与I／R组比较，IPC组和LRIPOC组心肌梗死体积、血清cTnI和CK-MB浓度显著降低，IPC组再灌注30、60、120min时血清TNF咀浓度、再灌注60、120min时血清HMGB．1浓度、再灌注120min时血清ICAM．1、IL．1和IL-6浓度显著降低，缺血区心肌组织内TNF-a、HMGB-1、ICAM-1、IL-1和IL-6含量显著降低，非缺血区�Objective To compare the effects of ischemic preconditioning with limb remote ischemic postconditioning on inflammatory response during myocardial ischemia/reperfusion injury （URI） in rat in vivo. Methods Eighty male Sprague-Dawley rats weighing 250 g-350 g were randomly allocated into four groups （n=20 in each group）： sham group （S group）; ischemia reperfusion group （I/R group）; ischemic preconditioning group （IPC group） and limb remote ischemic posteonditioning group （LRIPOC group）. In the groups other than the sham group, the myocardial ischemia reperfusion model was preparated by ligation of left anterior descending coronary artery for 30 min followed by 120 min reperfusion. During the process of ischemia and reperfusion,HR and MAP were recorded and the rate pressure product （RPP） at every measuring point was calculated as the index of myocardial oxygen consumption. In ten rats randomly selected from each group, the blood samples were collected from jugular vein at 30, 60 min and 120 min after reperfusion. Then, serum concentrations of cardiac troponin I （cTnI）, creatine kinase-MB （CK-MB）, tumor necrosis factor ot （TNFa）, high mobility group box-1 protein （HMGB-1）, intercellular adhesion molecule 1 （ICAM-1）, interleukin- 1 （IL-1）, IL-6 and IL-10 were all assessed. At the end of experiment, the infarct volumes were assessed by evans blue and triphenyltetrazolium chloride （YrC） staining. In another ten rats randomly selected from each group, the myocardial contents of TNF- a, HMGB-1, ICAM-1, IL-1, IL-6 and IL-10 in ischemic and non-ischemic regions were all measured after the rats were euthanized. Results The infarct volume was （72±9）% in I/R group, （36±13）% in IPC group, and （57±9）% in LRIPOC group, respectively. And the serum concentration of cTnI was （0.99±0.14） μg/L in I/R group, （0.37±0.08） μg/L in IPC group, and （0.54±0.07） μg/L in LRIPOC group, separately. In addition, the serum concentration of CK-MB was （110±1

关 键 词：心肌缺血 再灌注损伤 炎症反应 缺血预处理 肢体远隔缺血后处理 

分 类 号：R54[医药卫生—心血管疾病]