消融左侧星状神经节对犬急性心肌缺血后缝隙连接蛋白43表达的影响  

Effects of left stellate ganglion ablation on connexin43 expression during acute myocardial ischemic

作　　者：刘珊[1] 鲁志兵[1] 罗达 余小梅[1] 王晓莹 瞿唯一 胡慧慧[1] 马瑞松 江洪[1] LIU Shan;LU Zhi-bing;LUO Da;YU Xiao-mei;WANG Xiao-ying;QU Wei-yi;HU Hui-hui;MA Rui-song;JIANG Hong(Department of Cardiology,Renmin Hospital of Wuhan University,Cardiovascular Research Institute of Wuhan University,Wu-ban 430060,China)

机构地区：[1]武汉大学人民医院心内科武汉大学心血管病研究所湖北省心血管病重点实验室,湖北武汉430060

出　　处：《中国心脏起搏与心电生理杂志》2018年第4期398-402,共5页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金(81370281;81400250);湖北省自然科学基金杰青项目(2015CFA051)

摘　　要：目的探讨消融左侧星状神经节(LSG)对犬急性心肌缺血后缝隙连接蛋白43表达的影响。方法 18只成年杂种犬随机分为三组:假手术组(SO,n=6)、心肌梗死组(MI,n=6)、消融组(n=6)。SO组游离LSG而不予以射频能量,暴露左前降支但不予以结扎;MI组游离LSG但不行消融术,暴露左前降支,穿线结扎;消融组在消融LSG后30 min再结扎左前降支。记录SO组和消融组消融前后30min内心率变异性[(HRV,包括低频(LF)、高频(HF)、LF/HF值]的变化,记录各组MI后1 h内室性心律失常发生情况。蛋白免疫印记法(Western blot)检测各组内缝隙连接蛋白43(Cx43)的总量及磷酸化的表达变化。逆转录聚合酶链反应(PCR)分析各组内Cx43 mRNA的表达变化。结果 SO组消融前后HF、LF及LF/HF无明显差异。与消融前相比,消融组消融后LF值和LF/HF值显著降低,HF值明显升高。SO组无室性心律失常发生。与MI组相比,消融组室性早搏、成对室性早搏及非持续性室性心动过速的发作次数、持续时间明显降低(P均<0.05)。与SO组相比,MI组Cx43蛋白、磷酸化Cx43蛋白及Cx43 mRNA含量显著降低(P均<0.05)。与MI组相比,消融组Cx43蛋白、磷酸化Cx43蛋白及Cx43 mRNA含量显著升高,但与SO组相比无明显差异。结论消融LSG可降低心脏交感神经活性,上调心肌梗死后心肌Cx43的表达有抗心律失常作用。Objective To evaluate the effects of left stellate ganglion （LSG） ablation on connexin43 expression during acute myocardial ischemia （AMI） in canines. Methods Eighteen adult mongrel male dogs were randomized into the sham operation group （SO,n=6）,MI group （n=6） and LSG ablation plus MI （n=6）.The dogs underwent LSG ablation before left anterior descending （LAD） occlusion in ablation group, while only LAD occlusion without ablation was performed in the MI group.In the SO group, the LAD and LSG were exposed without ligation and abla- tion.Heart rate （HR） was measured be{ore and after ablation or sham ablation in the SO group and the ablation group.Ventricular arrhythmias was recorded during 1-hour of AMI.Then the animals were sacrificed and myocardial specimens were removed for determination of the expression of Cx43 protein （by Western blot） and mRNA （by RT PCR）. Results In the group,no significant differences were seen in HF components,LF components and LF/HF. LSG ablation significantly reduced the LF components and I.F/HF, and increased the HF eomoonents cnrnnared withbaseline （all P〈0.05）.There were no ventricular ar- rhythmias in SO group.Compared with MI group,LSG ablation signi{icantly decreased the incidence of isolated ventricular premature beats, the number of double ven- tricular premature beats, the occurrence and the dura- tion of ventricular tachycardia （all P〈0.05）.Compared with SO group, the levels ofphosphorylated Cx43 proteinand total Cx43 protein were significantly decreased in MI group （P〈0.05） ,whereas LSG ablation markedly reduced the degradation of Cx43 expression as compared with MI group （P〈0.05）. Conclusion The present study showed that the antiarrhythmic effect of LSG ablation during AMI may be exerted by modulating the cardiac sympathetic nerve activity to increase the expression of Cx43. [Chinese Journal of Cardiac Pacing and Electrophysiology, 2018, 32（4） ：398-402]

关 键 词：心血管病学 左侧星状神经节 急性心肌缺血 室性心律失常 缝隙连接蛋白43 

分 类 号：R541.7[医药卫生—心血管疾病] R454.1[医药卫生—内科学]