低温联合右美托咪定对家兔心室复极时程和CX43蛋白表达的影响  

The Effect of Hypothermia Combined with Dexmedetomidine on Duration of Ventricle Repolarization and the Expression of CX43

作　　者：李惠[1] 高鸿[2] 赵艳[3] 安丽[2] 刘艳秋[2] 龙娟[1] 张凯强[1] LI Hui GAO Hong ZHAO Yan AN Li LIU Yanqiu LONG Juan ZHANG Kaiqiang(School of Anesthesiology, Guizhou Medical University, Guiyang 550004, Guizhou, China Department of Anesthesiology, the Affiliated Hospital of Guizhou Medical University, Guiyang 550004, Ghuizhou, China Department of Anesthesiology, the First People＇s Hospital of Guiyang City, Guiyang 550002, Guizhou, China)

机构地区：[1]贵州医科大学麻醉学院,贵州贵阳550004 [2]贵州医科大学附院麻醉科,贵州贵阳550004 [3]贵阳市第一人民医院麻醉科,贵州贵阳550002

出　　处：《贵州医科大学学报》2017年第3期275-278,共4页Journal of Guizhou Medical University

基　　金：贵州省科技厅联合基金项目[黔科合LH字(2016)7252号];贵州省大学生创新创业训练计划项目(201510660022)

摘　　要：目的:探讨低温联合右美托咪定对心室复极时程和CX43蛋白表达的影响。方法:成年家兔制备Langendorff离体心脏灌注模型,取模型制备成功的心脏18个,随机均分为正常对照组(C组)、低温组(H组)、低温联合右美托咪定组(HD组),C组继续灌注37℃K-H液60 min,H组灌注32℃K-H液60 min,HD组灌注32℃含25μg/L右美托咪定的K-H液60 min;于平衡灌注末(T0)、灌注K-H液15(T_1)、30(T_2)和60 min(T_3)时记录心率和3层心肌单相动作电位,测量单相动作电位复极50%时程(MAPD_(50))和单相动作电位复极90%时程(MAPD_(90)),记录完毕后取左心室前壁心肌组织进行western blot检测CX43蛋白表达。结果:与C组T0时点比较,H组及HD组T1-3时HR减慢,心肌MAPD_(50)和MAPD_(90)延长(P<0.05);与C组比较,H组及HD组T1-3时HR减慢,心肌MAPD_(50)和MAPD_(90)延长(P<0.05);与C组比较,H组和HD组CX43蛋白表达明显降低(P<0.05)。结论:CX43蛋白的表达下降可能是低温造成心室复极不均一性增大的原因,而右美托咪定既不影响CX43蛋白表达,也不加重低温对心室复极时程的的影响。Objective：To evaluate the effect of hypothermia combined with dexmedetomidine（ DEX）on duration of ventricle repolarization and the expression of CX43. Methods：Eighteen Langendorff perfused heart models were prepared from adult New Zealand white rabbits,and randomly divided into3 groups（ n = 6） ：control group（ group C）,hypothermia group（ group H）,and hypothermia plus DEX group（ group HD）. Continuous perfusion was conducted for 60 mins to different groups with different solutions：37℃ Krebs-Henseleit（ K-H） solution for group C,32 ℃ K-H for group H,and 32℃K-H plus DEX at 25 ng/ml for group HD. The heart rate and 3-layer myocardial monophasic action potential（ MAP） of left ventricular anterior wall were recorded immediately after perfusion balanced（ T0） and in 15 min（ T1）,30 min（ T2）,and 60 min（ T3） after perfusion balanced were recorded.The durations of repolarization at 50%（ MAPD50）,and 90%（ MAPD90） were tested. Finally,sections of the left anterior ventricular wall were taken and CX43 protein expression was detected with Western blot. Results：Compared with group C,group H and group HD showed longer MAPD50,and MAPD90 and decreased protein expression of CX43（ P〈0. 05）,and there was no statistically significant difference between groups H and HD（ P〉0. 05）. Conclusion：The decreased expression of CX43 might be the reason for extension of the duration of repolarization caused by hypothermia.Dexmedetomidine has no influence on CX43 expression,or effect of hypothermia.

关 键 词：连接蛋白43 低温 右美托咪定 心脏跨室壁复极离散度 兔 

分 类 号：R614[医药卫生—麻醉学] R459.7[医药卫生—外科学]