钙调节蛋白对七氟烷处理再灌注心律失常的影响  

Effects of calcium regulatory protein on sevoflurane conditioning reperfusion arrhythmia

作　　者：于洋[1] 崔博群 林多茂[1] 马骏[1] YU Yang;CUI Boqun;LIN Duomao;MA Jun(Department of Anesthesiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所麻醉科,100029

出　　处：《心肺血管病杂志》2023年第5期492-499,共8页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:七氟烷对离体大鼠心脏再灌注心律失常的影响的探究。方法:在血流动力学稳定30min后,缺血20min,再灌注60min,建立缺血再灌注损伤模型。参考相关发表大鼠动物模型文献[1-2]将50只大鼠随机分成以下5组,每组10只:时间对照组(TC):用95%氧合KH液恒流在离体心脏内灌流110 min;缺血/再灌注组(I/RI):连续灌流95%氧合KH液30min后停止20min,恢复灌流60min;七氟烷预处理组(sevofluranepreconditioning,Sevo PC):离体心脏用95%氧合KH液灌流20 min,用95%氧合的3%七氟烷饱和KH混合液灌流10 min,停止20 min,恢复灌流60 min;七氟烷后处理组(sevofluranepostconditioning,Sevo Po C):离体心脏用95%氧合KH液灌流30 min,停止20 min,用95%氧合的3%七氟烷饱和KH混合液灌流10 min,恢复灌流50 min;七氟烷联合处理组(sevofluranepreconditioning and postconditioning,PCPO):离体心脏用95%氧合KH液灌流20min,用95%氧合的3%七氟烷饱和KH混合液灌流10min,停止20 min,使95%氧合的3%七氟烷饱和KH混合液灌流10min,恢复灌流50 min。持续监测各组HR,左心室发展压力(left ventricular developed pressure,LVDP),最大LVDP上升率(+dp/dt),最大LVDP下降率(-dp/dt)。监测并统计再灌注心律失常发生率。LTCC、RyR2和NCX1的蛋白和转录水平分别通过Westernblot和RT-PCR进行检测。用荧光分光光度计检测并比较每组细胞中的钙离子水平。结果:七氟烷干预的三组大鼠在再灌注30min、60min后的心功能均有改善,表现为LVDP、+dp/dt、-dp/dt和HR的改善(P<0.05),LVEDP下降(P<0.01)。再灌注心律失常的发生可由SevoPC和SevoPoC改善,表现为室性期前收缩(ventricular premature beat,VPB)总数下降。室性心动过速(ventricular tachycardia,VT)、心室颤动(ventricular fibrillation,VF)发作时程缩短,VF发生率下降,心律失常再灌注评分下降等。SevoPC组RyR2在转录水平的表达明显减少;在SevoPoC组中,转录水平的LTCC、RyR2、NCX1的表达和RyR2、NCX1的翻译水平均�Objective:To investigate the effect of sevoflurane on the reperfusion arrhythmias in an isolated rat heart model and explore the related mechanism.Methods:After 30-minute balanced perfusion,isolated hearts were subjected to 20-minute ischemia followed by 60-minute reperfusion,50 isolated hearts were randomly assigned to 5 groups(n=10):Time control(TC)group:continuous perfusion for 110 minutes;Ischemia/reperfusion(I/RI)group:After 30-minute balanced perfusion,ischemia for 20 minutes followed by 60-minute reperfusion;Sevofluranepreconditioning(SevoPC)group:After 20-minute balanced perfusion,perfused with 3%(v/v)sevoflurane-bubbled KHBs oxygenated with 95%oxygen for 10 minutes before 20 minutes of global ischemia and 60 minutes of reperfusion;Sevofluranepostconditioning(SevoPoC)group:After 30-minute balanced perfusion and 20 minutes of global ischemia,perfused with 3%(v/v)sevofluranebubbled KHBs oxygenated with 95%oxygen for 10 minutes at the onset of reperfusion and then with normal KHBs for the remaining 50 minutes;PCPo group:After 20-minute balanced perfusion,perfused with 3%(v/v)sevoflurane-bubbled KHBs oxygenated with 95%oxygen for 10 minutes before 20 minutes of global ischemia and then perfused with 3%(v/v)sevoflurane-bubbled KHBs oxygenated with 95%oxygen for 10 minutes at the onset of reperfusion and then with normal KHBs for the remaining 50 minutes.Heart rate(HR),left ventricular developed pressure(LVDP),and maximum LVDP increase(+dp/dt)and decrease(-dp/dt)rate were continuously collected.The reperfusion arrhythmias were measured.and the protein and messenger RNA(mRNA)levels of LTCCs,RyR2,and NCX1 were determined.Intracellular calcium levels of all groups were compared with the Fluorescence spectrophotometer.Results:Compared with I/RI goup,SevoPC group,SevoPoC group and PCPo group could improve the isolated rat heart function after reperfusion 30 min and 60 min,manifested by improved LVDP,+dp/dt,-dp/dt and HR(P<0.05),reduced LVEDP(P<0.05).SevoPC and SevoPoC could improve the occurring of reperfusion arrhy

关 键 词：七氟烷预处理 七氟烷后处理 缺血再灌注损伤 钙调节蛋白 再灌注心律失常 

分 类 号：R54[医药卫生—心血管疾病]