迷走神经-M受体通路在鞘内吗啡后处理减轻大鼠心肌缺血再灌注损伤中的作用  

Role of vagus nerve-muscarinic cholinergic receptor pathway in mitigation of myocardial ischemia-reperfusion injury by intrathecal morphine postconditioning in rats

作　　者：何伟天 蒋玲玲[1] 何淑芳[1] 胡军[1] 张野[1] 

机构地区：[1]安徽医科大学第二附属医院麻醉科,合肥市230601

出　　处：《中华麻醉学杂志》2015年第5期612-615,共4页Chinese Journal of Anesthesiology

基　　金：国家自然科学基金青年科学基金（81200089）

摘　　要：目的：评价迷走神经-M受体通路在鞘内吗啡后处理减轻大鼠心肌缺血再灌注损伤中的作用。方法鞘内置管成功的健康成年雄性SD大鼠70只，体重250～350 g，采用随机数字表法分为7组（ n＝10）：假手术组（ Sham组）、心肌缺血再灌注组（ I∕R组）、鞘内注射吗啡后处理组（ MP组）、颈部双侧迷走神经离断组（ VT组）、VT＋MP 组、M受体拮抗剂阿托品＋MP 组（ ATP＋MP 组）和ATP组。采用结扎左冠状动脉缺血30 min恢复灌注的方法制备大鼠心肌缺血再灌注损伤模型。 MP组于再灌注即刻鞘内输注吗啡3μg∕kg 10μl，持续5 min；I∕R组输注生理盐水10μl，持续5 min；VT＋MP组于再灌注前10 min离断颈部双侧迷走神经；ATP＋MP 组于再灌注前10 min静脉输注阿托品0．1 mg∕kg 0．5 ml，持续5 min。于再灌注30 min内记录室性心律失常[室性早搏（ PVCs）及室速∕室颤（VT∕VF）]发生次数。于再灌注120 min时处死大鼠后取心肌组织，测定梗死区（IS）和缺血危险区（ AAR）体积，计算IS∕AAR比值。结果与Sham组比较，其余各组PVCs和VT∕VF发生次数增加， IS∕AAR比值升高（P＜0．05）；与I∕R组比较，MP 组PVCs和VT∕VF发生次数减少，IS∕AAR比值降低（P＜0．05）；与MP组比较，VT＋MP组和ATP＋MP组PVCs和VT∕VF发生次数增加，IS∕AAR比值升高（ P＜0．05）。结论迷走神经-M受体通路参与了鞘内吗啡后处理减轻大鼠心肌缺血再灌注损伤的过程。Objective evaluate the role of vagus nerve-muscarinic cholinergic receptor （ M recep-tor） pathway in mitigation of myocardial ischemia-reperfusion （I∕R） injury by intrathecal morphine postcon-ditioning in rats. Methods Seventy adult male Sprague-Dawley rats in which intrathecal catheters were suc-cessfully placed without complications, weighing 250-350 g, were randomly assigned into 7 groups （ n=10 each） using a random number table：sham operation group （Sham group）, I∕R group, intrathecal morphine postconditioning group （ MP group） , vagal transection （ VT） group, VT＋ intrathecal morphine postcondi-tioning group （VT＋MP group）, atropine （ATP, M receptor antagonist） ＋ morphine postconditioning group （ ATP＋MP group） , and ATP group. Myocardial I∕R was produced by occlusion of the anterior descending branch of left coronary artery for 30 min followed by 2 h of reperfusion. Morphine （ 3μg∕kg, 10μl） was in-trathecally infused over 5 min starting from onset of reperfusion in MP group. Normal saline 10 μl was in-trathecally infused over 5 min starting from onset of reperfusion in NS group. The bilateral vagus nerves were transected at 10 min before reperfusion in VT＋MP group. Atropine （ 0-1 mg∕kg, 0-5 ml） was intravenously infused over 5 min starting from 10 min before reperfusion in ATP＋MP group. The occurrence of cardiac arrhythmia （ premature ventricular contractions （ PVCs） and ventricular tachycardia （ VT）∕ventricular fibrilla-tion （ VF） ） within the first 30 min of reperfusion was recorded. The rats were sacrificed at 120 min of reper-fusion, and myocardial specimens were obtained for determination of myocardial infarct size （ IS） as a per-centage of area at risk （AAR）. IS∕AAR ratio was calculated. Results Compared with Sham group, the number of PVCs and VT∕VF and IS∕AAR ratio were significantly increased in the other groups. Compared with I∕R group, the number of PVCs and VT∕VF and IS∕AAR ratio were signifi

关 键 词：迷走神经 受体 毒蕈碱 吗啡 注射 脊髓 心肌再灌注损伤 缺血后处理 

分 类 号：R614[医药卫生—麻醉学]