高压氧对家兔心肌缺血再灌注损伤的防治作用  

Effects of hyperbaric oxygen treatment on myocardial ischemiareperfusion injury in rabbits

作　　者：刘明新[1] 陶贵周[1] 刘奇峰[1] 

机构地区：[1]辽宁医学院附属第一医院心内科,辽宁锦州121001

出　　处：《现代预防医学》2014年第10期1848-1851,共4页Modern Preventive Medicine

基　　金：辽宁省医学高峰建设工程项目(2010075)

摘　　要：目的观察不同时间段给予高压氧(HBO)处理对家兔心肌缺血再灌注损伤的防治作用。方法 32只家兔随机等分为4组:心肌缺血再灌注组(I/R组)、高压氧预处理组(HBO-P组)、缺血期HBO治疗组(HBO-I组)和再灌注期HBO治疗组(HBO-R组)。I/R组在结扎前降支1 h后恢复血流灌注,HBO-P组在制作模型前高压氧治疗1 h,HBO-I组在心肌缺血时高压氧治疗1 h,HBO-R组在恢复血流灌注后高压氧治疗1 h。再灌注3 h后测定心功能指标、血清肌酸磷酸激酶(CK)、乳酸脱氢酶(LDH)的含量。原位末端标记法测定心肌凋亡阳性细胞指数(AI)。结果与I/R组比较,HBO-P组和HBO-I组左心室收缩压(LVSP)、左心室舒张末压(LVEDP)及左心室内压最大上升速率(+dp/dtmax)明显好转(P<0.01),CK和LDH明显降低(P<0.05),心肌凋亡阳性细胞指数明显降低(P<0.01);而HBO-R组虽有改善,但差异无统计学意义(P>0.05)。结论高压氧治疗可以有效防治心肌缺血再灌注损伤,但治疗时机不同效果也不同。在缺血前和缺血期应用HBO治疗均有效,再灌注期应用则无效。Objective The research was designed to evaluate the effects of hyperbaric oxygen （HBO） treatment given in different periods on myocardial ischemia-reperfusion injury in rabbits. Methods Thirty-two rabbits were randomly and averagely divided into four groups： myocardial ischemia-reperfusion group （I/R group）, pretreatment HBO group （HBO-P group）, ischemia period HBO treatment group （HBO-I group）, and reperfusion HBO treatment group （HBO-R group）. After one hour＇s occlusion of anterior descending artery, the blood flow was restored in I/R group. HBO-P group were given HBO treatment for one hour before ischemia period. HBO-I group were given HBO treatment for one hour during ischemia period. HBO-R group were given HBO treatment for one hour during reperfusion period. Left ventricular function indexes, serum creatine phosphokinase （CK） levels, lactate dehydrogenase （LDH） levels were measured after reperfusion for three hours. The positive apoptotic index （AI） of cardiac muscle was calculated with TUNEL methodology. Results Compared with I/R group, left ventricular systolic pressure （LVSP）, left ventricular end diastolic pressure （LVEDP） and the maximal rate of left ventricular pressure rise （＋dp/dtmax） of HBO-P group and HBO-I group were significantly improved （P〈0.01）. CK and LDH levels were significantly decreased （P〈0.05）. The positive apoptotic index was signifi- cantly reduced （P〈0.01）. Although these indicators for HBO-R group had some improvement, the difference was not statistically significant （P〉0.05）. Conclusion HBO treatment can prevent myocardial ischemia-reperfusion injury, but the effects were varied for different time. It was effective when HBO treatment was administered before or during ischemia period. There was no effect when HBO therapy was given during reperfusion period.

关 键 词：高压氧 缺血再灌注损伤 细胞凋亡 心功能 

分 类 号：R319[医药卫生—基础医学]