慢性心肌梗死大鼠室性心律失常的实验研究  

Omentopexy Decreasing the Susceptibility of Ventricular Arrhythmia in Experimental Rats With Chronic Myocardial Infarction

作　　者：侯剑峰[1] 张昌伟[1] 郑哲[1] 胡盛寿[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外心血管病医院心血管疾病国家重点实验室,北京市100037

出　　处：《中国循环杂志》2014年第11期924-927,共4页Chinese Circulation Journal

基　　金：国家国际科技合作项目(2010DFA32620);北京市科技新星计划(Z111107054511080);协和青年科研基金项目(2013XHQN03)

摘　　要：目的:证实大网膜是否通过逆转心脏神经重构降低心律失常易感性。方法:将大鼠随机分为3组:假手术组(n=20),单纯心肌梗死组(n=20)和大网膜移植组(n=20)。4周后分别采用电生理方法评价各组大鼠的电生理特性,免疫组织化学方法检测心脏神经分布及密度,蛋白免疫印迹检测连接蛋白43(Connexin43)、神经生长因子(NGF)的表达,酶联免疫吸附法检测心肌组织内皮素-1(ET-1)的表达。结果:与单纯心肌梗死组相比,大网膜移植组大鼠心律失常易感性显著下降(评分:0.9±0.2 vs 3.5±1.2,P<0.05),电传导阻滞得到显著改善[信号振幅(:3.4±0.3)mV vs(1.5±0.2)mV,P<0.05;捕获阈值(:2.2±0.2)mV vs(5.5±0.3)mV,P<0.05];免疫组织化学显示大网膜包裹显著降低了心肌梗死周边区新生神经以及交感神经密度[神经生长相关蛋白-43(GAP43)(:768.6±144.1)μm2/mm2 vs(1388.4±244.9)μm2/mm2,P<0.05;酪氨酸酶(TH)(:1018.5±124.7)μm2/mm2 vs(1552.4±270.3)μm2/mm2,P<0.05];蛋白免疫印迹结果表明大网膜移植组NGF表达下调而Connexin43的表达上调,酶联免疫吸附法显示大网膜移植组ET-1的表达下调(P<0.05)。结论:大网膜包裹能减低慢性心肌梗死大鼠心律失常易感性,而且这种作用可能与心肌梗死后心脏神经重构的逆转有关。Objective： To conifrm the omentopexy decreasing the susceptibility of ventricular arrhythmia in experimental rats with chronic myocardial infarction （MI） by nerve remodeling. Methods： The MI model of SD rats was established by left coronary artery ligation. 3 weeks later, the qualiifed animals were randomized into 3 groups for the 2nd operation. ① Sham operation group, the rats received the 2nd operation without ligation, ② Isolated MI group, the rats received the 2nd operation without omentopexy, ③ Omentopexy group, the rats received the 2nd operation with omentopexy. n=20 in each group. 4 weeks after the 2nd operation, the electrophysiological characteristics were assessed by relevant techniques, the new and sympathetic nerves in MI border zone were examined by immunohistochemistry, the protein expressions of connexin43 and nerve growth factor （NGF） were measured by western blot analysis and the cardiac endothelin-1 （ET-1） level was evaluated by ELISA. Results： Compared with Isolated MI group, Omentopexy group showed decreased susceptibility of arrhythmia （3.5 ± 1.2） vs （0.9 ± 0.2）, improved electrical transduction （1.5 ± 0.2） mV vs （3.4 ± 0.3） mV and decreased capture threshold （5.5 ± 0.3） mV vs （2.2 ± 0.2） mV, all P〈0.05. Compared with Isolated MI group, immunihistochemisty indicated that Omentopexy group had decreased new and sympathetic nerves in MI border zone, as for GAP43：（1388.4 ± 244.9）μm2/mm2 vs （768.6 ± 144.1）μm2/mm2, for TH：（1552.4 ± 270.3）μm2/mm2 vs （1018.5 ± 124.7）μm2/mm2, all P〈0.05. Western blot analysis showed that Omentopexy group had the lower NGF expression and higher connexin43 expression;ELISA demonstrated that Omentopexy group had the lower ET-1 expression, P〈0.05. Conclusion： Omentopexy may decrease the susceptibility of ventricular arrhythmia after MI in experimental rats, which might be related to the cardiac nerve remodeling.

关 键 词：大网膜移植 心肌梗死 心律失常 神经重构 

分 类 号：R54[医药卫生—心血管疾病]