亚低温治疗对AMI模型大鼠炎性反应的作用及心肌保护机制分析  

Analysis of the Effect of Mild Hypothermia on Inflammatory Response in AMI Model Rats and the Mechanism of Myocardial Protection

作　　者：王艳丽[1] 高仁俊 王显艳[2] 赵红晔[3] 肖章博 张鑫蕊 蔡彧 宗浩 李懿桐 张凤娇 WANG Yan-li;GAO Ren-jun;WANG Xian-yan;ZHAO Hong-ye;XIAO Zhang-bo;ZHANG Xin-rui;CAI Yu;ZONG Hao;LI Yi-tong;ZHANG Feng-jiao(Section Six,Department of Cardiology,Second Affiliated Hospital of Qiqihar Medical College,Qiqiar,Heilongjiang Province,161006 China;Department of Pathology,Qiqihar Medical College,Qiqihar,Heilongjiang Province,161006 China;Department of Physiology,Qiqihar Medical College,Qiqiar,Heilongjiang Province,161006 China;Clinical Skills Center of Second Hospital of Qiqihar Medical College,Qiqihar,Heilongjiang Province,161006 China)

机构地区：[1]齐齐哈尔医学院附属第二医院心内六科,黑龙江齐齐哈尔161006 [2]齐齐哈尔医学院病理教研室,黑龙江齐齐哈尔161006 [3]齐齐哈尔医学院生理教研室,黑龙江齐齐哈尔161006 [4]齐齐哈尔医学院附属第二医院临床技能中心,黑龙江齐齐哈尔161006

出　　处：《中外医疗》2020年第17期31-34,共4页China & Foreign Medical Treatment

基　　金：黑龙江省省属本科高校基本科研业务费科学技术研究项目(2017-QYKYYWF-0761)。

摘　　要：目的研究亚低温治疗对急性心肌梗死(AMI)模型大鼠炎性反应的作用及心肌保护机制。方法选取80只SD级健康大鼠,通过结扎冠状动脉左前降支的方式制作AMI模型。成功后按随机抽签法分成亚低温组及对照组,各40只。对照组造模成功后予以生理盐水,维持体温在36~38℃之间。亚低温组造模成功后静脉输注4℃生理盐水,诱导亚低温状态(32~35℃)。分别采集结扎术前、术后1 h、2 h、3 h、4 h以及冠脉再灌注后1h时两组大鼠的静脉血1 mL,检测肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTnI)、脑钠肽(BNP)、C反应蛋白(CRP)、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平。结果结扎前1 h、结扎后1 h两组大鼠CK-MB、cTnI、BNP水平对比均差异无统计学意义(P>0.05);结扎后2 h、3 h、4 h及再灌注1 h后亚低温组大鼠的CK-MB、cTnI、BNP水平均低于对照组(t=8.517、14.114、17.018、10.016、2.314、2.388、4.530、5.839、5.612、2.170、4.463、3.409,P<0.05)。结扎前1 h、结扎后1 h两组大鼠CRP、IL-6、TNF-α水平对比均差异无统计学意义(P>0.05);结扎后2 h、3 h、4 h及再灌注1 h后亚低温组大鼠的CRP、IL-6、TNF-α水平均低于对照组(t=3.707、5.550、9.606、16.595、2.398、4.362、4.231、4.184、5.323、7.995、6.589、8.072,P<0.05)。结论亚低温治疗可显著改善AMI模型大鼠炎性反应,从而发挥心肌保护作用,值得临床重点关注。Objective To study the effect of mild hypothermia on the inflammatory response and myocardial protection mechanism of acute myocardial infarction(AMI)model rats.Methods 80 healthy SD rats were selected to make an AMI model by ligating the left anterior descending coronary artery.After success,they were divided into a mild hypothermia group and a control group of 40 by random drawing.The control group was given normal saline after successful modeling to maintain body temperature between 36-38°C.After successful modeling in mild hypothermia group,intravenous infusion of 4℃normal saline was induced to induce mild hypothermia(32-35℃).Collect 1ml of venous blood of two groups of rats before ligation,1 h,2 h,3 h,4 h after operation and 1h after coronary reperfusion to detect creatine kinase isoenzyme(CK-MB)and troponin(cTnI),brain natriuretic peptide(BNP),C-reactive protein(CRP),interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)levels.Results The levels of CK-MB,cTnI and BNP in the two groups of rats were not statistically significant difference 1 h before ligation and 1h after ligation(P>0.05);2 h,3 h,4 h after ligation and 1h after hypoperfusion levels of CK-MB,cTnI and BNP were lower than those of the control group(t=8.517,14.114,17.018,10.016,2.314,2.388,4.530,5.839,5.612,2.170,4.463,3.409,P<0.05).The levels of CRP,IL-6 and TNF-αin the two groups of rats were not statistically significant difference at 1h before ligation and 1h after ligation(P>0.05);the rats in mild hypothermia group 2 h,3 h,4 h after ligation and 1h after reperfusion levels of CRP,IL-6 and TNF-αwere lower than those of the control group(t=3.707,5.550,9.606,16.595,2.398,4.362,4.231,4.184,5.323,7.995,6.589,8.072,P<0.05).Conclusion Mild hypothermia treatment can significantly improve the inflammatory response of AMI model rats,thereby exerting the protective effect of myocardium,which deserves clinical attention.

关 键 词：急性心肌梗死 大鼠 亚低温治疗 炎性反应 心肌保护机制 

分 类 号：R54[医药卫生—心血管疾病]