经腰部硬膜外阻滞肾脏交感神经对心肌梗死大鼠心脏功能及血清炎症因子的影响  

Effects of lumbar epidural block of renal sympathetic nerve on cardiac function and serum infla-mmatory factors in rats with myocardial infarction

作　　者：王硕 王玉淼 刘晴 杨鑫 杨孟丽 殷婕 岳修勤[1] WANG Shuo;WANG Yumiao;LIU Qing;YANG Xin;YANG Mengli;YIN Jie;YUE Xiuqin(Department of Anesthesiology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院麻醉科,河南卫辉453100

出　　处：《新乡医学院学报》2024年第8期706-711,共6页Journal of Xinxiang Medical University

基　　金：国家自然科学基金资助项目(编号:81870926);河南省高等学校重点科研项目资助计划项目(编号:18B310020);河南省医学科技攻关计划省部共建项目(编号:2018054)。

摘　　要：目的探讨经腰部硬膜外阻滞肾脏交感神经对心肌梗死大鼠心脏功能及血清炎症因子的影响。方法将30只健康雄性Sprague Dawley大鼠按随机数字表法分为假手术组、心肌梗死组、交感神经阻滞组,每组10只。3组大鼠均采用腰段硬膜外置管。置管后,心肌梗死组和交感神经阻滞组大鼠结扎左冠状动脉前降支诱导心肌梗死,假手术组大鼠仅在左冠状动脉前降支穿线不结扎。心肌梗死术后,交感神经阻滞组大鼠经腰段硬膜外置管注射体积分数0.2%罗哌卡因50μL,每隔24 h注射1次,注射持续至术后14 d;心肌梗死组大鼠经腰段硬膜外置管注射9 g·L^(-1)氯化钠注射液50μL,每隔24 h注射1次,注射持续至术后14 d;假手术组不注射任何药物。术后14 d,3组大鼠行超声心动图检查,测量射血分数(EF)、左心室短轴缩短率(FS)和心输出量(CO);术后24 h时抽取3组大鼠颈静脉血1 mL,术后14 d时抽取3组大鼠腹主动脉血5 mL,应用酶联免疫吸附试验检测血清中去甲肾上腺素(NE)、心肌肌钙蛋白I(cTnI)、白细胞介素-18(IL-18)、白细胞介素-1β(IL-1β)和肿瘤坏死因子-α(TNF-α)水平;术后14 d,3组大鼠腹腔注射100 g·L^(-1)水合氯醛(300 mg·kg^(-1))麻醉后,打开大鼠胸腔,迅速取下心脏,应用2,3,5-三苯基氯化四氮唑染色检测大鼠心肌梗死面积,计算心肌梗死面积比例。结果术后14 d,心肌梗死组和交感神经阻滞组大鼠EF、FS、CO显著低于假手术组,交感神经阻滞组大鼠EF、FS、CO显著高于心肌梗死组(P<0.05)。心肌梗死组和交感神经阻滞组大鼠血清中cTnI水平显著高于假手术组(t=68.260、15.110,P<0.05);心肌梗死组大鼠血清中cTnI水平显著高于交感神经阻滞组(t=27.920,P<0.05)。交感神经阻滞组大鼠心肌梗死面积比例显著低于心肌梗死组(t=14.182,P<0.001)。假手术组大鼠术后24 h与术后14 d血清中NE、IL-18、IL-1β和TNF-α水平比较差异无统计学意义(P>0.05);心肌Objective To investigate the effects of lumbar epidural block of renal sympathetic nerve on cardiac function and serum inflammatory factors in rats with myocardial infarction.Methods Thirty healthy male Sprague Dawley rats were divided into asham operation group,myocardial infarction group and sympathetic nerve block group according to the random number table method,with 10 rats in each group.Lumbar epidural catheterization was applied in all rats in the 3 groups.After catheter insertion,myocardial infarction was induced by ligation of the anterior descending branch of the left coronary artery of rats in the myocardial infarction group and the sympathetic nerve block group,while the left anterior descending branch of rats in the sham operation group was not ligated.After myocardial infarction,the rats in the sympathetic nerve block group were injected with 50μL of ropivacaine(volume fraction:0.2%)via a lumbar epidural catheteronce every 24 hours,and the injection lasted until 14 days after surgery.In the myocardial infarction group,50μL of 9 g·L^(-1) sodium chloride was injected into the rats through a lumbar epidural catheteronce every 24 hours,and the injection lasted until 14 days after surgery.Rats in the sham group did not receive the injection of any drugs.At 14 days after operation,echocardiography was performed on rats in the 3 groups to measure ejection fraction(EF),left ventricular short-axis shortening rate(FS)and cardiac output(CO).A total of 1 mL of cervical venous blood was extracted from each rat in the 3 groups at 24 h after surgery,and 5 mL of abdominal aortic blood was extracted from rats in the 3 groups at 14 days after surgery.Serum levels of norepinephrine(NE),cardiac troponin I(cTnI),interleukin-18(IL-18),interleukin-1β(IL-1β)and tumor necrosis factor-α(TNF-α)were detected by enzyme-linked immunosorbent assay.At 14 days after surgery,the rats in the 3 groups were anesthetized by intraperitoneal injection of 100 g·L^(-1) chloral hydrate(300 mg·kg^(-1)),and the thoracic cavity of the

关 键 词：心肌梗死 腰部硬膜外置管 肾脏交感神经阻滞 心脏功能 炎症因子 

分 类 号：R542.2[医药卫生—心血管疾病]