新生猪缺氧及复苏后心功能变化及其与心肌β1和β2肾上腺素能受体表达的关系  

Relationships of cardiac compromise after hypoxic injury and expression of β1 and β2 adrenoceptors in a neonatal swine model of asphyxia

作　　者：胡雪峰[1] 黄丽萍[1] 贲晓明[1] 刘江勤[1] 

机构地区：[1]同济大学附属上海市第一妇婴保健院新生儿科,200040

出　　处：《中华围产医学杂志》2014年第9期621-627,共7页Chinese Journal of Perinatal Medicine

摘　　要：目的 探讨新生猪缺氧及复苏后心脏功能变化及心肌损伤机制. 方法 日龄l～4 d新生猪随机分为对照组（n=6）、缺氧急性期组（n=8）和缺氧亚急性期组（n=8）.对照组动物维持空气机械通气50 h;缺氧急性期组动物机械通气缺氧2h（氧浓度0.10～0.15）后空气机械通气（复苏）4h;缺氧亚急性期组缺氧2h后复苏48 h.监测缺氧处理前、缺氧2h末以及复苏过程中的血气分析、血压及血流动力学指标.复苏结束后分离左心室,采用Western印迹技术测定心肌组织β1和β2肾上腺素能受体表达,采用酶学法检测心肌组织乳酸、谷胱甘肽和氧化型谷胱甘肽含量.统计学方法采用方差分析、Tukey检验及Pearson相关分析.结果 缺氧急性期组及缺氧亚急性期组缺氧2h末pH、HCO3-和氧分压均较对照组下降（P值均＜0.05）,缺氧亚急性期组复苏后pH及HCO3-分别恢复至7.38±0.05和（23.04±2.40） mmol/L,明显高于缺氧急性期组[分别为7.25±0.07和（16.88±2.40） mmol/L]（q值分别为6.76和7.81,P值均＜0.01）,与对照组比较差异无统计学意义（P值均＞0.05）.缺氧急性期组及缺氧亚急性期组新生猪缺氧2h末平均动脉压、心输出量和每博心输出量均较对照组显著下降,而心率明显加快,差异均有统计学意义（P值均＜0.05）.复苏期间,缺氧急性期组及缺氧亚急性期组新生猪平均动脉压恢复至（42.17±6.14）和（43.19±5.55）mmHg（l mmHg=0.133 kPa）,心输出量恢复至（150.04±56.17）和（169.75±37.85） dl/min,与对照组差异无统计学意义（P值均＞0.05）.缺氧亚急性期组新生猪心肌β1和β2肾上腺素能受体表达分别为1.51±0.51和2.14±0.66,均高于对照组（分别为0.56±0.24和0.38±0.21,q值分别为7.02和10.97,P值均＜0.01）和缺氧急性期组（分别为0.65±0.20和0.45±0.11,g值分别为6.86和11.38,P值均＜0.01）.乳酸水平在缺氧急性期组和缺氧亚急性期组均高于对照组[（6.95Objective To investigate the hemodynamic changes and their association with the expression of β 1 and β 2 adrenoceptors after hypoxia-reoxygenation injury in a neonatal swine model of asphyxia.Methods One to four day-old piglets were randomly assigned to control group （n=6）,acute hypoxia group （n=8） and subacute hypoxia group （n=8）.The piglets in the control group were observed for 50 h under normoxic mechanical ventilation; while the acute and subacute hypoxia groups were subject to two hours of hypoxic injury induced by ventilation with 0.10-0.15 oxygen followed by 4 or 48 h of observation under normoxic mechanical ventilation,respectively.Blood gases were analyzed and the mean arterial blood pressure,heart rate,and cardiac output were recorded at different time points during the experiment.Tissues from the left ventricle were also harvested to assay lactate,glutathione and β adrenoceptors at the end of the experiment.Analysis of variance,the Tukey test and Pearson correlation analysis were used for statistical analysis of the data.Results Two hours after hypoxia,pH,HCO3-and partial pressure of oxygens （PO2） in the acute hypoxia group and subacute hypoxia group were lower than in the control group,however,pH and HCO3-in animals in the subacute hypoxia group recovered to 7.38 ± 0.05 and （23.04± 2.40）mmol/L,respectively,after reoxygenation,which was similar to those in the control group,and higher than in the acute hypoxia group [7.25±0.07 and （16.88±2.40） mmol/L,respectively,q=6.76 and 7.81,both P〈0.01].Mean arterial pressure,cardiac output and stroke volume in the acute group and subacute group were lower than those in the control animals following two hours of hypoxic injury （all P〈0.01）.After reoxygenation,the mean arterial pressure in the acute hypoxia group and subacute group recovered to （42.17±6.14） and （43.19± 5.55） mmHg （1 mmHg=0.133 kPa）,cardiac output recovered to （150.04± 56.17） and （169.75 ± 37.85） dl/min,respectively,and there were no d

关 键 词：窒息 新生儿 缺氧 每搏输出量 受体 肾上腺素能 动物 新生 

分 类 号：R544.1[医药卫生—心血管疾病]