脓毒症大鼠心肌细胞凋亡及糖皮质激素的作用  

The effects of glucocorticoid on myocardial apoptosis in septic rats

作　　者：张寒钰[1] 杨立沛[1] 谢苗荣[1] 

机构地区：[1]首都医科大学附属北京友谊医院急诊科,北京100050

出　　处：《中华急诊医学杂志》2014年第10期1105-1108,共4页Chinese Journal of Emergency Medicine

摘　　要：目的 观察脓毒症状态下大鼠心肌细胞凋亡的变化并探讨糖皮质激素对心肌细胞凋亡的影响及其机制,为临床治疗脓毒症心脏损害提供依据.方法 采用盲肠结扎穿孔术制作脓毒症模型.60只体质量为230 ～ 280 g的Wistar大鼠被随机（随机数字法）分为糖皮质激素实验组（n=30）和对照组（n=30）.每组大鼠均行盲肠结扎穿孔术,每组术后4h开始给予舒普深200 mg/kg,2次/d.实验组在以上基础上给予地塞米松0.5 mg/kg.每组随机分为3个亚组（6、24、72 h组）,于相应时间点取出各组大鼠心脏,分离左心室,制备单细胞悬液,进行流式细胞仪检测心肌细胞凋亡率.使用SPSS 11.5统计软件系统,所有数据以均数±标准差表示（（x-）±s）,两组间采取独立样本t检验,多组间数据比较采用单因素方差分析.同时左心室行免疫组化检测抗细胞凋亡蛋白B淋巴细胞瘤/白血病-2（B-cell lymphoma/leukemia-2,Bcl-2）的表达.结果 激素组大鼠各时间点心肌细胞凋亡率分别较对照组大鼠心肌细胞凋亡率明显减少（F=9.11,t=5.681,P＜0.01）（6 ht =11.416,P＜0.01;24 h=6.217,P＜0.01;72 h t=3.76,P＜0.01）;6h对照组大鼠的心肌细胞凋亡率显著低于24 h及72 h对照组大鼠（F=13.254,sig =0.000,P＜0.01;sig=0.004,P＜0.01）;24 h对照组大鼠的心肌细胞凋亡率显著高于72 h对照组大鼠（sig=0.039,P＜0.05）;激素各组大鼠心肌细胞凋亡率差异无统计学意义（F=2.488,6/24 h sig=0.132,P＞0.05; 24/72 h sig=0.549,P＞0.05;6/72 h sig=0.053,P＞0.05）.结论 脓毒症时存在心肌细胞凋亡,以24 h最明显,脓毒症时应用糖皮质激素能够减少各个阶段心肌细胞凋亡.Objective To observe the occurrence of myocardial apoptosis and discussing the mechanism of the effects of glucocorticoid on myocardial apoptosis in septic rats in order to provide the rationale for clinical strategy.Methods A total of 60 Wistar rats weighing 230-280 g were randomly （random number） divided into control group and experimental group （n =30 in each group）.Cecal ligation and puncture （CLP） was performed in rats to induce sepsis,and Cefoperazone Sodium/Sulbactam Sodium （200 mg/kg） was injected into caudal vein 4 hours after CLP,twice a day.In addition,glucocorticoid was given to rats of experimental group.After rats sacrificed,their left ventricular myocardia were rapidly taken out and myocardial apoptosis rate was measured and the level of Bcl-2 was assayed at 6 h,24 h,and 72 h after CLP.Measured data were analyzed with independent-samples t-test and One-Way ANOVA.Results The rates of myocardial apoptosis in experimental group were obviously lower than those in control groups respectively （F=9.11,t=5.681,P＜0.01） （6ht=11.416,P＜0.01; 24ht=6.217,P＜0.01; 72 h t =3.76,P ＜0.01）.The rates of myocardial apoptosis in 24 h in control and 72 h control groups were distinctively higher than those in 6 h control group,respectively （F =13.254,sig =0.000,P ＜0.01 ; sig =0.004,P ＜ 0.01）.The rates ofmyocardial apoptosis in group 24 h control were higher than those in 72 h control group （sig =0.039,P ＜ 0.05）.The rates of myocardial apoptosis make no difference among experimental group （F =2.488,6/24 h sig =0.132,P ＞ 0.05 ; 24/72 h sig =0.549,P ＞ 0.05 ; 6/72 h sig =0.053,P ＞ 0.05）.Conclusions The rate of myocardial apoptosis is peaked at 24 h in sepsis rat,and the rate of myocardial apoptosis can be obviously decreased by administration of glucocorticoid.

关 键 词：脓毒症 WISTAR大鼠 盲肠结扎穿孔术 糖皮质激素 免疫组化 Bcl-2 流式细胞学 心肌细胞凋亡 

分 类 号：R459.7[医药卫生—急诊医学]