多疗程无创性延迟肢体缺血预适应保护大鼠心肌缺血再灌注损伤的持久效应研究  

Long-term cardioprotective effects of multiple courses noninvasive delayed limb ischemic preconditioning against myocardial ischemia-reperfusion injury in rats

作　　者：高建波[1,2] 张颖[2] 娄建石[2] 

机构地区：[1]天津市药品检验所,天津300070 [2]天津医科大学

出　　处：《临床心血管病杂志》2014年第5期439-442,共4页Journal of Clinical Cardiology

基　　金：国家自然科学基金资助项目(No.81072631);天津市自然科学基金资助项目(No.09JCZDJC21100)

摘　　要：目的:探讨多疗程无创性肢体缺血预适应保护大鼠心肌缺血再灌注损伤持久效应差别,确定最佳的临床应用方案。方法:雄性Wistar大鼠按体重随机进行如下分组:①对照组,包括假手术组、缺血再灌注组、心肌缺血预适应组、股动脉缺血预适应组;②无创性延迟肢体缺血预适应组,包括1d远端肢体缺血预适应间隔1d组、1d远端肢体缺血预适应间隔2d组、3d远端肢体缺血预适应间隔3d组、3d远端肢体缺血预适应间隔5d组。每组分别在间隔末期进行缺血再灌注损伤、监测缺血再灌注期间左心室心功能、心律失常、ST段升高幅度,检测再灌注结束时心脏脂肪酸结合蛋白(H-FABP)和糖原磷酸化酶同工酶BB(GPBB)及心肌梗死面积。结果:与缺血再灌注组比较,心肌缺血预适应组、1d远端肢体缺血预适应间隔1d组明显改善左心室功能、减少心律失常、降低ST段抬高幅度、降低H-FABP和GPBB活性、减少心肌梗死面积。结论:多疗程1d远端肢体缺血预适应,间隔1d可提供长期的心肌保护,有望成为临床应用的最佳方案。Objective：To test the difference between multiple courses of noninvasive delayed limb ischemic preconditioning（NDLIP）for lasting（long-term）cardioprotection and provide the optional strategy for clinical application.Method：Male Wistar rats were randomized into the following groups：control groups and consecutive NDLIP groups.The control groups included the sham operation group,the ischemia-reperfusion（I/R）group,the myocardial ischemic preconditioning（MIPC）group,the femoral artery ischemic preconditioning（FAIP）group. NDLIP groups included 1-day NDLIP＋1-day interval（INTV）group,1-day NDLIP＋2-day INTV group,3-day NDLIP ＋3-day INTV group,3-day NDLIP＋5-day INTV group.Left ventricular function,incidence of ventricular arrhythmia,and ST-segment were measured during I/R.Myocardial infarct size,heart fatty acid binding protein（H-FABP）,and glycogen phosphorylase BB（GPBB）were determined at the end of experiment.Result：Compared to the I/R group,the MIPC,FAIP,1-d NDLIP ＋1-d INTV group showed amelioration of ventricular arrhythmia,improved left ventricular function,lower ST-segment elevation,reduced myocardial infarct size, decreased H-FABP,and GPBB activity.Conclusion：Multiple courses of 1-d NDLIP＋1-d INTV regimen may provide lasting cardioprotection and may be the optional strategy for clinical application.

关 键 词：多疗程 肢体缺血预适应 心肌缺血再灌注 心肌保护 方案 

分 类 号：R541.4[医药卫生—心血管疾病]