脓毒症大鼠早期ET-1、NO、E-选择素的表达及米力农对脓毒症大鼠心肌损伤的保护作用  

Expression of ET-1,NO and E-selectin and the Protective Effect of Milrinone on Myocardial Injury in Sepsis Rats in Early Stage

作　　者：徐盈[1,2] 陈国兵[1,2] 苏洁[1,2] 钟玲[1,2] 吴海燕[1,2] 施湘平[1,2] 吴燕萍[1,2] 

机构地区：[1]云南省第一人民医院 [2]昆明医学院附属昆华医院急诊ICU,昆明650032

出　　处：《华中科技大学学报（医学版）》2013年第2期195-199,共5页Acta Medicinae Universitatis Scientiae et Technologiae Huazhong

摘　　要：目的探讨脓毒症大鼠内皮素-1(ET-1)、一氧化氮(NO)、血清E-选择素的改变和米力农注射液对脓毒症大鼠血管内皮细胞及心肌损伤的保护作用及其可能机制。方法 SD雄性大鼠60只,随机分为对照组、假手术组、模型组及米力农小剂量组、大剂量组。采用盲肠结扎穿孔术(CLP)建立脓毒症模型,24h后取动脉血及左室心肌,检测血清E-选择素、心肌肌钙蛋白I(cTnI)、心肌同工酶CK-MB,心肌组织匀浆上清液肿瘤坏死因子(TNF-α)、内皮素-1(ET-1)、NO、E-选择素水平,观察心肌组织病理学改变。结果模型组血清cTnI、CK-MB、NO、ET-1、E-选择素及心肌TNF-α、ET-1、NO水平较正常对照组明显升高(均P<0.01);米力农小剂量组上述指标水平与模型组比较差异无统计学意义;米力农大剂量组上述指标水平较模型组明显降低(均P<0.01)。结论大剂量米力农对脓毒症心肌损伤具有保护作用,其机制可能通过抑制ET-1、NO及血清E选择素的表达而实现;小剂量米力农对脓毒症心肌损伤无保护作用。Objective To investigate the change of endotheliwl （ET-1）,nitric oxide（NO）and E selectin in sepsis rats in early stage and the protective effect of milrinone on vascular endothelial cells and myocardia injury. Methods A total of 60 male SD rats were randomly divide into control group, sham-operated group, model group, low-dose milrinone group and high dose group. The sepsis models were established by cecal ligation and puncture（CLP）. The arterial blood and left ventricular tissues were harvested 24 h later. Cardiac troponin I（cTnI）,CK-MB, tumor necrosis factor-α（TNF-α）,ET-1, NO and E-selectin levels were detected and the myocardial histopathological changes were observed. Results The levels of serum cTnI,CK-MB, ET-1, NO, E-selectin and the myocardial TNF-α, ET1, NO in the model group were significantly higher than in the normal con- trol group（P〈0.01）. There were no significant difference in these indices between the model group and low-dose milrinone group. But these indices in the high-dose milrinone group were significantly lower than in the model group（P〈0. 01）. Conclu- sion High dose of milrinone has protective effects on the myocardial damage in sepsis rats,the mechanism of which may be a- chieved by inhibiting the expression of ET-1 ,NO and serum E-selectin. Low dose of milrinone has no protective effects on the myocardial damage in sepsis rats.

关 键 词：脓毒症 心肌肌钙蛋白I 肿瘤坏死因子-α 内皮素-1 一氧化氮 E-选择素 

分 类 号：R631.2[医药卫生—外科学]