机械创伤后肾动脉内皮依赖性舒张功能改变与迟发性心功能不全的关系  

Relationship between change of renal artery endothelium-dependent diastolic function and delayed heart failure after mechanical trauma

作　　者：曹成章[1] 燕子[2] 温永金[1] 王洁[2] 郭丽[4] 郭勇 牛龙刚[1] 梁峰[5] 

机构地区：[1]山西医科大学研究生学院,太原030001 [2]山西医科大学基础医学院生理学系 [3]解剖教研室 [4]山西医科大学附属第二医院骨科实验室 [5]山西医科大学附属太钢总医院胸心外科

出　　处：《中华创伤杂志》2013年第4期348-352,共5页Chinese Journal of Trauma

基　　金：国家自然科学基金资助项目

摘　　要：目的观察肾动脉舒张功能改变与机械创伤致迟发性心功能不全的关系。方法Wistar大鼠28只（意外死亡4只）按随机数字表法分为伪创伤组和创伤组，创伤组又分为创伤后6h和24h组，每组8只；利用Noble—Collip机械创伤仪制备机械创伤模型，通过离体心脏灌流技术检测大鼠左心室内压上升最大速率（＋dR／dt）、左心室内压下降最大速率（-dp／dt）的变化，离体微血管环技术检测肾动脉舒张功能的改变，ELISA检测血清和心肌组织血管紧张素Ⅱ（an-giotensinⅡ，Angll）水平。结果与伪创伤组比较，创伤后24h组大鼠离体心功能明显下降，且创伤后6h组大鼠肾动脉血管环对乙酰胆碱（acetylcholine，Ach）引起的最大内皮依赖性舒张反应显著下降；创伤后6，24h组血清和心肌组织AngII含量显著升高，呈正相关；心肌组织AngII含量变化与＋dp／dt呈负相关，与-dR／dt呈正相关。结论机械性创伤可能通过引起肾动脉内皮依赖性舒张功能障碍而导致随后的心功能下降，AnglI的过度激活可能在其中发挥着重要作用。Objective To investigate correlation between change of renal artery diastolic function and subsequent heart failure following mechanical trauma. Methods Twenty-eight Wistar rats, of which four died from accidents, were divided randomly into sham group and trauma group （ subgroups at 6 hours and 24 hours after trauma）, with 8 rats per group. Models of mechanical trauma in rats were created by Noble-Collip drum. Maximum rate of left ventricular pressure rise （ ＋ dp/dtm~ ） and fall （ - dp/dtm~） in rats were detected through isolated heart perfusion technique. Alteration of renal artery diastolic function was observed by isolated micro-vessel technique. Contents of angiotensin I1 （Ang II ） in serum and myocardium tissue were tested by ELISA method. Results In vitro heart function in the group at 24 hours after trauma showed significant decrease and maximum endothelium-dependent diastolic response of renal artery vascular ring to acetylcholine （Ach） in the group at 6 hours after trauma showed obvious decrease, as compared with the sham group. Ang lI contents in serum and myocardium tissue in the groups at 6 and 24 hours after trauma were significantly higher than those in the sham group and appeared to be positively correlated. Meantime, Ang ]1 contents in myocardium tissue were negatively related to ＋ dp/dtm^x, but was positively correlated with - dp/dtm=. Conclusions Mechanical trauma may induce subsequent cardiac insufficiency by disturbing renal artery endothelium-dependent diastolic function. Moreover, excessive activation of Ang II may play an important role in the entire process.

关 键 词：创伤和损伤 肾动脉 内皮 血管 血管紧张素Ⅱ 

分 类 号：R541.6[医药卫生—心血管疾病]