电针对心肌缺血再灌注损伤大鼠心室结构和功能的影响  

Effect of electroacupuncture on ventricular structure and function in rats with myocardial ischemia-reperfusion injury

作　　者：吴双 姜文 丁雅萍 刘琼琼 白桦 徐森磊 张宏如[4] 夏铭徽[2] 顾一煌[1] WU Shuang;JIANG Wen;DING Ya-ping;LIU Qiong-qiong;BAI Hua;XU Sen-lei;ZHANG Hong-ru;XIA Ming-hui;GU Yi-huang(School of Acupuncture-Moxibustion and Tuina,School of Health Preservation and Rehabilitation,Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Acupuncture and Moxibustion,Affiliated Hospital of Nantong University,Nantong 226001,Jiangsu Province;"Department of Neurology,Nantong Hospital Affliated to Nanjing University of Chinese Medicine,Nantong 22600l,Jiangsu Province;School of Chinese Medicine,School of Integrated Traditional and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023)

机构地区：[1]南京中医药大学针灸推拿学院养生康复学院,南京210023 [2]南通大学附属医院针灸科,江苏南通226001 [3]南京中医药大学南通附属医院脑病科,江苏南通226001 [4]南京中医药大学中医学院·中西医结合学院,南京210023

出　　处：《针刺研究》2024年第1期6-14,共9页Acupuncture Research

基　　金：国家自然科学基金面上项目(No.81974583);江苏省中医药领军人才项目(No.SLJ0226);南京中医药大学校自然科学基金青年项目(No.NZY81704169)。

摘　　要：目的:观察电针对心肌缺血再灌注损伤(MIRI)大鼠心室结构和功能的影响,探讨电针改善MIRI后心室重塑的潜在机制。方法:将40只雄性SD大鼠随机分为假手术组、模型组、电针组、LCZ696(阳性药对照)组,每组10只。通过冠状动脉左前降支结扎法建立MIRI模型。电针组取双侧“内关”进行电针治疗,每次20 min,隔日1次;LCZ696组每日按60 mg·kg^(-1)·d^(-1)的剂量予LCZ696灌胃。以上干预连续21 d。采用超声心动图检测各组大鼠左心室射血分数(EF)和短轴缩短指数(FS);酶联免疫吸附法检测各组大鼠血清中肿瘤坏死因子α(TNF-α)、血管细胞黏附分子1(VCAM-1)、细胞间黏附分子1(ICAM-1)含量;HE染色法观察大鼠心肌组织病理形态变化;Masson染色法观察大鼠心肌组织胶原沉积情况及心肌纤维化程度;荧光定量PCR法检测大鼠心肌组织中心肌纤维化标志物CollagenⅠ、CollagenⅢ、CTGF mRNA表达水平;Western blot法检测大鼠心肌组织炎性因子IL-1β、IL-18表达水平。结果:与假手术组比较,模型组大鼠左心室EF、FS降低(P<0.001);血清中TNF-α、VCAM-1、ICAM-1含量增加(P<0.001);心肌纤维排列紊乱,并伴有炎性细胞浸润,心肌组织胶原沉积增多,心肌胶原纤维面积占比升高(P<0.0001);心肌组织中CollagenⅠ、CollagenⅢ、CTGF mRNA表达水平均升高(P<0.05,P<0.01),IL-1β、IL-18表达水平升高(P<0.000 1)。与模型组比较,电针组和LCZ696组大鼠EF、FS升高(P<0.01);血清中TNF-α、VCAM-1、ICAM-1含量减少(P<0.001,P<0.01);部分心肌细胞排列紊乱,炎性细胞浸润程度明显减轻,心肌组织胶原沉积减少,心肌胶原纤维面积占比降低(P<0.01);心肌组织中CollagenⅠ、CollagenⅢ、CTGF mRNA表达水平均降低(P<0.05),IL-1β、IL-18表达水平降低(P<0.01,P<0.05)。结论:电针能够改善MIRI大鼠心室结构和功能,其机制可能与下调心肌炎性反应,抑制MIRI后心肌组织中CollagenⅠ、CollagenⅢ、CTGF mRNA的表达水Objective To observe the effect of electroacupuncture(EA) on changes of ventricular structure and function in rats with myocardial ischemia-reperfusion injury(MIRI), so as to explore its potential mechanisms underlying improvement of ventricular remodeling after MIRI. Methods Forty male SD rats were randomly divided into 4groups: sham operation group, model group, EA group and medication(sacubactril valsartan, LCZ696) group, with 10 rats in each group. The MIRI model was established by ligation of the left anterior descending coronary artery and reperfusion. EA(2 Hz/100 Hz, 2 mA) was applied to bilateral “Neiguan”(PC6) for 20 min, once every other day for 21 d. Rats of the medication group received gavage of LCZ696(60 mg·kg^(-1)·d^(-1)). After the intervention, echocardiography was used to detect the ejection fraction(EF) and fractional shortening(FS) of the left ventricle, and the contents of serum tumor necrosis factor-α(TNF-α), vascular cell adhesion molecule-1(VCAM-1) and intercellular cell adhesion molecule-1(ICAM-1) were assayed by enzyme-linked immunosorbent assay. The pathological changes of myocardial tissue were observed after HE staining. The Masson staining was used to evaluate the myocardial collagen deposition and myocardial fibrosis. The mRNA expression levels of collagen Ⅰ and Ⅲ and connective tissue growth factor(CTGF) in the myocardial tissue were detected by quantitative real-time PCR, and the expression levels of IL-1β and IL-18 were detected by Western blot. Results In contrast to the sham operation group, the EF and FS levels of the left ventricle were obviously decreased(P<0.001), while the contents of serum TNF-α, VCAM-1 and ICAM-1, the proportion of myocardial fibrosis area, the mRNA expression levels of myocardial collagen Ⅰ, collagen Ⅲ and CTGF, the expression levels of IL-1β and IL-18 were significantly increased(P<0.001, P<0.000 1, P<0.05, P<0.01) in the model group. Compared with the model group, the EF and FS levels were remarkably increased(P<0.01), whereas the c

关 键 词：心肌缺血再灌注损伤 电针 心室重塑 心肌纤维化 炎性反应 

分 类 号：R245[医药卫生—针灸推拿学]