缺血后适应对兔心肌急性缺血-再灌注损伤的影响  

Effects of myocardial ischemic postconditioning on acute ischemia-reperfusion injury in rabbit hearts

作　　者：薛枫[1] 杨向军[1] 韩莲花[1] 李勋[1] 蒋廷波[1] 蒋文平[1] 

机构地区：[1]苏州大学附属第一医院心内科, 江苏 苏州215006

出　　处：《中国急救医学》2014年第4期372-375,共4页Chinese Journal of Critical Care Medicine

基　　金：江苏省卫生厅“江苏省医学创新团队与领军人才”资助项目（LJ201140）

摘　　要：目的：研究缺血后适应对兔在体心肌急性缺血-再灌注损伤的影响。方法36只新西兰大白兔随机（随机数字法）分为三组：对照组（缺血-再灌注组）、缺血后适应组（ IPostC组）和假手术组。建模方法为结扎左前降支。实验中全程心电监护，再灌注前后应用ELISA法测定血清肌钙蛋白浓度。再灌注结束后测定各组心肌梗死面积，并应用电镜行组织形态学观察，同时行Western Blot检测心肌Bad蛋白表达。结果①再灌注120 min时对照组和IPostC组ST段下降50％的比例分别为67％和83％，但组间差异无统计学意义（ P＞0．05）。对照组心律失常评分明显高于IPostC组[（2．5＆#177;1．0）分vs（1．4＆#177;1．0）分，P＜0．05]。②再灌注120 min时对照组血清cTnI浓度明显高于IPostC组[（6．63＆#177;2．32）ng/mL vs （3．04＆#177;1．10）ng/mL，P＜0．05]。③对照组心肌梗死面积较IPostC组增加54％（ P＜0．05）。④电镜发现对照组心肌细胞超微结构凋亡特征比IPostC组明显，同时其心肌Bad蛋白表达也明显高于IPostC组（0．69＆#177;0．05 vs 0．26＆#177;0．06，P＜0．05）。结论缺血后适应能明显减少心肌缺血-再灌注损伤。Objective To study the cardioprotective effects of ischemic postconditioning on rabbit heart injuried by ischemia/reperfusion in vivo .Methods Thirty-six New Zealand rabbits were randomly allocated to three groups： ①Control group （ ischemia/reperfusion group ）; ②Ischemic postconditioning group （ IPostC group ）; ③Sham operation group （ sham group ） . Models were established by the method of left anterior descending artery occlusion .Electrocardiogram （ ECG ） were performed during the experiment .Blood was drawn from femoral vein to evaluate cardiac troponin I （ cTnI ） by enzyme -linked immunosorbent assay （ ELISA ） before operation and 120 min after reperfusion .Myocardial infarct size of each group was determined by staining with triphenyltetrazolium chloride dye.Morphology of cardiac muscle tissues in each group was examined by transmission electron microscope .Bad expressions in the cardiac muscle tissues were detected by Western blot before and after reperfusion .All experiment data were statistically analyzed by the SPSS 17.0 software.Results ①One hundred and twenty minutes after reperfusion sixty -seven percent of rabbits in control group and eighty-three percent of rabbits in IPostC group had ST -segment resolution ≥50%.But there was no significant difference between two groups （P＆gt;0.05）.The cardiac arrhythmia score of control group increased significantly than that of IPostC group （2.5 ＆#177;1.0 vs 1.4 ＆#177;1.0, P＆lt;0.05）.②One hundred and twenty minutes after reperfusion cTnI value of control group was higher than that of IPostC group （6.63 ＆#177;2.32 vs 3.04 ＆#177;1.10, P＆lt;0.05）.③Compared to IPostC group the infarct size of control group increased by 54%（P＆lt;0.05）.④Morphologic examination indicated that the cardiomyocytes of control rabbits had more significant apoptosis characteristics compared with those of IPostC rabbits .Control group was associated with a significant increase in the expression of Bad compared with IPostC

关 键 词：缺血后适应 缺血-再灌注 心肌梗死 兔心脏 ISCHEMIC POSTCONDITIONING ( IPostC) 

分 类 号：R-332[医药卫生]