参附注射液减少老龄小鼠心肌缺血再灌注心律失常的研究  

Study on protection of a Shenfu injection against myocardial ischemia-reperfusion arrhythmias in aged mice

作　　者：郭志佳[1] 王成钢[2] 贺忠梅[3] 田首元[1] Guo Zhijia;Wang Chenggang;He Zhongmei;Tian Shouyuan(Department of Anesthesia,the First Hospital of Shanxi Medical University,Taiyuan 030001,China;Department of Anesthesia and Operation Room,Shanxi Traditional Medicine Hospital,Taiyuan 030012,China;Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第一医院麻醉科,太原030001 [2]山西省中医院麻醉手术科,太原030012 [3]山西医科大学,太原030001

出　　处：《中华老年医学杂志》2019年第9期1058-1061,共4页Chinese Journal of Geriatrics

基　　金：山西医科大学博士启动基金(03201553);山西医科大学第一医院博士基金(YB161711).

摘　　要：目的探讨参附注射液预处理对老龄小鼠心肌缺血再灌注损伤(IR)所致心律失常的保护作用。结果18月龄C57BL/6J小鼠30只,数字抽签随机分为3组(每组10只):(1)假手术组小鼠开胸不结扎;(2)IR组:结扎冠状动脉左前降支,缺血30 min再灌注2 h;(3)参附注射液预处理组(参附组):开胸前30 min腹腔注射参附(10 ml/kg),余处理同IR组。监测3组小鼠心律失常、血清肌酸激酶-同工酶(CK-MB)、肌钙蛋白(cTnI)水平,心肌组织肿瘤坏死因子α(TNFα)水平、心肌缝隙连接蛋白43(Cx43)磷酸化(ser368)与总蛋白比值(p-Cx43/t-Cx43)。结果IR组和参附组小鼠均发生心律失常;与IR组小鼠比较,参附组小鼠室性心律失常程度减轻,室性期前收缩发作次数减少[(36.6±13.5)次/min比(48.4±22.1)次/min]、室性心动过速/心室颤动发生帧数减少[(3.4±1.8)次/min比(7.6±3.5)次/min]、发作总时长缩短[(8.9±4.5)次/min比(17.7±5.1)次/min],均P<0.05;但心律失常评分差异无统计学意义(P>0.05)。与假手术组小鼠比较,IR组和参附组小鼠血清CK-MB、cTnI及心肌TNFα水平升高(均P<0.05);参附组小鼠CK-MB、cTnI、TNFα水平较IR组小鼠降低(均P<0.05)。Cx43 ser368/总蛋白比值降低(P<0.05)。与假手术组小鼠比较,IR组和参附组小鼠p-Cx43/t-Cx43减小[(0.28±0.11)和(0.34±0.16)比(0.46±0.11),P<0.05];参附组小鼠较IR组小鼠增大(P<0.05)。结论参附预处理能显著减少老龄小鼠IR所致心律失常,可能的机制是通过降低TNFα、上调Cx43磷酸化活性水平实现。Objective To investigate the protective effects of pretreatment with a Shenfu(SF)injection on arrhythmias induced by myocardial ischemia-reperfusion(IR)injury in aged mice.Methods Thirty 18-month-old C57BL/6J mice were randomly divided into 3 groups(n=10,each group):the sham treatment group(receiving sham operation without thoracotomy),the IR group(undergoing the ligation of the left anterior descending coronary artery with ischemia for 30 min and reperfusion for 2 h)and the SF group(receiving SF intraperitoneal injection of 10 ml/kg 30 min before thoracotomy and the same treatment as the IR group).Arrhythmias were monitored,and serum levels of creatine kinase-isoenzyme(CK-MB),troponin(cTnI)and tumor necrosis factorα(TNFα),and the ratio of myocardial connexin 43(Cx43)phosphorylation(ser368)to total protein(p-Cx43/t-Cx43)were detected in the three groups.Results Ventricular arrhythmias occurred in the IR and SF groups.Compared with the IR group,ventricular arrhythmias in the SF group were alleviated,the frequency of ventricular premature systolic episodes was reduced(36.6±13.5 times vs.48.4±22.1 times),the frequency of ventricular tachycardia/fibrillation decreased(3.4±1.8 times vs.7.6±3.5 times),and the total duration of ventricular tachycardia/fibrillation episodes was shortened(8.9±4.5 times vs.17.7±5.1 times)in the SF group(P<0.05),but there was no significant difference in arrhythmia scores(1.8±1.2 points vs.1.9±1.7 points,P>0.05)between the two groups.Compared with the sham treatment group,serum levels of CK-MB,cTnI and myocardial TNF(increased in the IR and SF groups(P<0.05),and their levels were lower in the SF group than in the IR group(P<0.05).Compared with the sham treatment group,the ratio of Cx43 ser368/total protein was lower in the IR and SF groups,but was higher in the SF group than in the IR group(P<0.05).Conclusions SF pretreatment can significantly reduce IR-induced arrhythmias in aged mice possibly by reducing TNF(and up-regulating the phosphorylation activity of Cx43.

关 键 词：参附注射液 心律失常 心性 心肌再灌注 连接蛋白类 

分 类 号：R285.5[医药卫生—中药学]