吡那地尔联合硝酸甘油预处理对兔缺血再灌注心肌细胞凋亡及血流动力学的影响  

Effect of pinacidil combined nitroglycerin procondioning on Apoptosis and hemodynamics of cardiac ischemia-reperfusion injury in rabbits

作　　者：刘文武 薛宪骏 马宾[3] 罗显元 葛以山 王学斌 李英 季伟敏 尹薇 朱晓晴 王杰 LIU Wen-wu;XUE Xian-jun;Ma Bin;LUO Xian-yuan;GE Yi-shan;WANG Xue-Bin;LI Ying;JI Wei-min;YIN Wei;ZHU Xiao-qing;WANG Jie(Jiangsu Suzhou Science and Technology City Hospital/Suzhou Hospital Affiliated to Nanjing Medical University,Jiangsu Suzhou 215153,China;Department of Cardiovascular Medicine,Ma'anshan City Central Hospital,Anhui Ma’anshan 243000,China;Department of Cardiovascular Medicine,First Affiliated Hospital,Bengbu Medical College,Anhui Bengbu 233000,China)

机构地区：[1]江苏省苏州科技城医院/南京医科大学附属苏州医院心内科,江苏苏州215153 [2]马鞍山市中心医院心血管内科,安徽马鞍山243000 [3]蚌埠医学院第一附属医院心血管内科,安徽蚌埠233000

出　　处：《临床医药文献电子杂志》2019年第90期9-11,13,共4页Electronic Journal of Clinical Medical Literature

摘　　要：目的观察吡那地尔联合硝酸甘油预处理对兔缺血再灌注心肌细胞凋亡及血流动力学影响。方法五十只家兔随机分为五组,每组10只。假手术组(SO)、缺血再灌注组(I/R)、吡那地尔组(PN)、硝酸甘油组(NG)、吡那地尔+硝酸甘油组(PN+NG)。各组分别于再灌注后30 min(T30)、60 min(T60)、90 min(T90)、150分钟(T150)采集左心室收缩压(LVSP)、左心室舒张压末压(LVEDP)及等容收缩期左心室内压上升最大速率(+dp/dtmax)等血流动力学指标。采用磷脂酰丝氨酸外翻分析方法(Annexin V法)检测家兔心肌凋亡情况。结果 1、血流动力学指标(1)LVSP(mmHg):在各时间点I/R、PN、NG、PN+NG组较SO组明显下降(P<0.01),在T150时:I/R组与NG、PN+NG组相比,LVSP值[(38.33±12.76)比(63.42±11.98)、(73.67±17.49)]下降(P<0.01),与PN(60.72±7.36)比下降(P<0.05)。PN、NG与PN+NG下降(P<0.01)。(2)LVEDP:在T30时各组没有显著差异,在T60、T90、T150时I/R均较SO、NG、PN+NG显著提高(P<0.01),在T60时:I/R与PN比(P<0.05);在T90时:PN+NG较SO升高(P<0.05);在T150时:PN较SO升高(P<0.01),NG较SO升高(P<0.05);2、PN+NG组心肌细胞凋亡少于I/R组(P<0.01),PN组、NG组(P<0.05);PN+NG组心肌细胞坏死少于I/R组(P<0.01),PN组、NG组(P<0.05);PN组、NG组细胞凋亡少于I/R组(P<0.01),但多于SO组(P<0.01)。结论吡那地尔、硝酸甘油预处理对兔心肌缺血再灌注心肌血流动力学具有有益作用,可以减少家兔缺血再灌注损伤所诱导的心肌细胞凋亡,联合应用优于单一应用。Objective to observed effect of pinacidil combined nitroglycerin procondioning on hemodynamics and Apoptosis of cardiac ischemia-reperfusion injury in rabbits.Methods 50 rabbits were randomly divided into five groups and each group of 10 rabbits.Sham-operation (SO)、ischemia-reperfusion group (I/R)、pinacidil group(PN)、nitroglycerin groups(NG)、pinacidil+ nitroglycerin group(PN+NG).respectively,Reperfusion 0 (T0),30 (T30),60 (T60),150 (T150) minutes to measure hemodynamic indexes of left heart systolic pressure (LVSP),left ventricular end-diastolic pressure (LVEDP) and maximum rate of increase of left ventricular pressure in constant volume systolic(+ dp/dtmax).Results Hemodynamic index:(1)LVSP (mmHg):At each time points LVSP in I/R,PN,NG,PN+NG groups was significantly decreased than that inSO group(P<0.01).At T150,compared with NG,PN+NG group,cardiac function indexes in I/R group as [(38.33±12.76)VS(63.42±11.98),(73.67±17.49)] was significantly decreased (P<0.05)and PN group(60.72±7.36),(P<0.05).PN,NG group were decreased than PN+NG group(P<0.01):(2)LVEDP:there was no significant difference among the groups at T30.At T60,T90 and T150,I/R was significantly higher than SO,NG and PN+NG (P<0.01).At T60:I/R and PN ratio (P<0.05).At T90,PN+NG was higher than SO (P<0.05).At T150,PN was higher than SO (P<0.01),and NG was higher than SO (P<0.05).2、The apoptosis of myocardial cells in the PN+NG group was less than that in the I/R group (P < 0.01),and that in the PN group and NG group (P<0.05).The myocardial cell necrosis in the PN+NG group was less than that in the I/R group (P < 0.01),and that in the PN group and NG group (P<0.05).The apoptosis of myocardial cells in the PN group and NG group were less than that of I/R group (P<0.01),but more than that of in the SO group (P<0.01).Conclusion nitroglycerin,pinacidil have beneficial effects on the hemodynamics of cardial and can reduce the apoptosis of myocardial cells after ischemia reperfusion injury in rabbits,combined than alone.

关 键 词：缺血再灌注 预处理 吡那地尔 硝酸甘油 血流动力学 ANNEXIN V 凋亡 

分 类 号：R54[医药卫生—心血管疾病]