硫化氢对大鼠心肺复苏后心肌细胞凋亡的影响  

Effects of hydrogen sulfide on apoptosis of cardiomyocytes after cardiopulmonary resuscitation in a ratmodel

作　　者：谢学猛[1] 潘昊[1] 刘蓓蓓[1] 陈娣[1] 张锦程[1] 杨光田[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院急诊科,武汉430030

出　　处：《中华急诊医学杂志》2014年第1期19-23,共5页Chinese Journal of Emergency Medicine

基　　金：国家自然科学基金（81071526）

摘　　要：目的研究外源性硫化氢（H2S）对心肺复苏后大鼠心肌细胞凋亡的影响。方法雄性SD大鼠45只，随机（随机数字法）分3组，每组15只：假手术对照组（Sham）；常规复苏组（CPR），经皮电刺激心外膜法制备心搏骤停模型，行常规复苏；硫氢化钠组（NariS），以NariS为H2S供体，CPR开始前1min静脉给药（总剂量5mg／kg），其余操作同CPR组。记录三组大鼠血流动力学指标变化。2，4h后取左室心肌组织TUNEL法检测心肌细胞凋亡；RT-PCR法检测Caspase-3、Bax和Bcl-2基因表达；ELISA法检测血浆肌钙蛋白T含量。三组数据采用单因素方差分析，组间比较采用SNK—q检验。结果与CPR组比较，NariS组LVSP、＋dp／dtmax、-dp／dtmax增高（P〈0．01），肌钙蛋白T含量降低（P〈Q05），心肌TUNEL阳性细胞比例降低（P〈0．01）。与Sham组比较，CPR组和NariS组心肌组织Caspase一3、Bax、Bcl．2基因表达不同程度增高（P〈n01）；与CPR组相比，NariS组Caspase-3、Bax基因表达降低（P〈Q01），Bcl一2基因表达增高（P〈0．05）。结论外源性H：s在心肺复苏后24h调节大鼠心肌Caspase-3、Bax和Bcl．2基因表达，减轻心肌细胞凋亡，减少心肌标志物释放，改善心功能。Objective To explore the effects of hydrogen sulfide （ H2S） on apoptosis of cardiomyocytes after cardiopulmouary resuscitation （CPR） in rat models. Methods Forty-five male SD rats were randomly into sham group （n -- 15）, CPR group （ n = 15） and NariS group （n = 15）. Rats of CPR group and NariS group were operated to induce cardiac arrest by transcutaneous electrical stimulation to epicardium. In NariS group, NariS （5 mg/kg） was administrated via the femoral venous line 1 rain before CPR. Hemodynamic variables were monitored and obtained continuously. Survival rats were sacrificed at 24 h after restoration of spontaneous circulation and the hearts were removed for analysis by RT-PCR and TUNEL assays. Blood samples were collected and plasma content of cTnT was detected. Results Compared with the CPR group, animals treated with NariS had improved left ventricular function （P 〈0. 01 ）, lower plasma cTnT levels （P 〈0. 05） and decreased apoptosis index （P 〈 0. 01） 24 h after ROSC. The expressions of Caspase-3 InRNA, Bax mRNA and Bcl-2 mRNA in CPR group and NariS group were higher compared with the control group （P 〈0. 01 ）. The NariS group had lower expressions of Caspase-3 mRNA and Bax mRNA （P 〈0. 01 ）, but higher expression of Bcl-2 mRNA （P 〈0. 05） compared with the CPR group. Conclusions Exogenous （H2S） regulated the expressions of Caspase-3, Bax and Bcl-2 mRNA, thereby preventing apoptosis of eardiomyocytes, inhibiting eTnT release and improving left ventricular function 24 h after CPR.

关 键 词：心肺复苏 心功能障碍 硫化氢 凋亡 

分 类 号：R459.7[医药卫生—急诊医学]